The Correct Answer is B!
Knowledge to Practice, in collaboration with Mayo Clinic, offers online board review and lifelong learning products in Cardiovascular Medicine. With a full pre-assessment, you can identify the topics you’ve mastered and focus your time on topics where you need it the most. Our products are proven to increase knowledge 75% more than traditional methods in less time.
Use promo code PREP200 to save $200 off any online cardiovascular medicine board review or lifelong learning product *
A 33 year-old man with a known bicuspid aortic valve is seen for follow-up. He is active, runs 2-3 miles per day and denies symptoms or any other medical problems. He is not on any medications. On exam, BP 122/40 and HR 55. Bounding carotid pulses with normal JVP and clear lung fields. The LV is displaced and enlarged. There is a 2/6 short SEM at the RUSB with an early peak and a long 3/6 diastolic decrescendo murmur is audible at the LSB. Echocardiography shows a dilated LV with EF 55% and ESD 41 mm and EDD 60 mm. There is a bicuspid aortic valve with a eccentric jet of AR with severe flow reversal in the descending aorta. There is a 8 mmHg mean gradient across the aortic valve. The aortic root and ascending aorta were well visualized and normal in size.
What is the next step in management?
- Start vasodilator and see in 3 months with echocardiogram.
- Continue observation with serial echocardiograms every 6 months.
- Proceed with AVR or repair
- Right and left heart catheterization with aortic root angiography
* Offer Expires March 15, 2019. Discounts and promotions are for new product purchases only. They do not apply to previously purchased products.