Facharzt FMH Allgemeine Innere Medizin Practice Questions - Facharzt FMH Für Allgemeine Innere Medizin Spécialiste FMH En Médecine Interne Générale Exam

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An 81-year-old male presents with progressive exertional dyspnea, angina, and an episode of near-syncope while walking uphill. Cardiac auscultation reveals a harsh, late-peaking systolic ejection murmur at the right upper sternal border radiating to the carotids, with a diminished and delayed carotid pulse (pulsus parvus et tardus). Echocardiography shows a mean aortic valve gradient of 48 mmHg, peak velocity of 4.3 m/s, and aortic valve area of 0.7 cm². What is the definitive treatment?

Aortic valve replacement (Surgical AVR or Transcatheter Aortic Valve Implantation - TAVI) evaluated by the Heart Team Balloon aortic valvuloplasty as definitive monotherapy Serial observation with repeat echocardiography in 12 months Long-term medical therapy with high-dose verapamil and ivabradine

Correct Answer:

Aortic valve replacement (Surgical AVR or Transcatheter Aortic Valve Implantation - TAVI) evaluated by the Heart Team

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