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7th March 2024
You are an IMT1 in cardiology. A 54-year-old male, is referred to you due to the results of his preoperative investigations for an elective hernioplasty.
You are an IMT1 in cardiology. A 54-year-old male, is referred to you due to the results of his preoperative investigations for an elective hernioplasty. He is normally fit and well and an avid cyclist. He has no past medical history. He smokes 10 cigarettes a day and drinks 12 units of alcohol per week. His father died of a heart attack at age 86. Examination reveals an irregular pulse and a soft ejection systolic murmur. The results of his investigations are as follows:
| Hb | 14 | Creatinine | 56 |
| WBC | 6.2 | eGFR | >90 |
| Neutrophils | 4 | TSH | 2.6 |
| Platelets | 400 | B12/Folate | Normal |
| Clotting Screen | Normal | ECG | Atrial Fibrillation |
| Na | 138 | Echocardiogram | Preserved LV function (LVEF 56%), mild bi-atrial dilatation, mild Aortic Stenosis, Mitral/Pulmonary/Tricuspid valve normal |
| K | 3.8 | ||
| Ur | 4.0 | ||
He is concerned about his aortic stenosis as one of his close friend’s father died of valve disease, however he does not know which. Of the options listed below, which would be the most appropriate management of his aortic stenosis?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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