RCPSC Internal Medicine Practice Questions - Royal College Certification Examination In Internal Medicine Exam

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A 70-year-old woman presents with exertional syncope, a slow-rising carotid pulse and a harsh late-peaking systolic murmur radiating to the carotids. Echocardiography shows a valve area of 0.8 cm2 and mean gradient of 50 mmHg. What is the most appropriate management?

Start a beta-blocker and reassess in one year Refer for aortic valve replacement Begin afterload reduction with an ACE inhibitor Reassure and arrange routine follow-up

Correct Answer:

Refer for aortic valve replacement

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