The Correct Answer is D!
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A 44 year-old man with a known bicuspid aortic valve presents with one year of increasing DOE. On exam, he has a BP 155/50, brisk pulses, and a 3/6 diastolic decrescendo murmur at the LSB. Echocardiography shows a dilated LV (LVEDD 68/LVESD 40) with EF 66%. There is a bicuspid aortic valve with a thin eccentric jet of AR, called mild AR in report. The aortic root is normal in size.
What is the next step in management?
- Surgical referral
- Observe with follow-up in 6 months
- Exercise MUGA
- Aortic root angiography
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