26th July 2024

A 72-year-old man with a metallic heart valve presents with fatigue

A 72-year-old man with a metallic heart valve presents with fatigue.

Initial blood tests show: Hb 82 (130-160), Plt 62 (150-400), Bilirubin 46 (<20), LDH 390 (<250) Haptoglobins < 0.05 (4.1-16.5).

Transthoracic echocardiogram shows a mildly regurgitant mitral valve with ejection fraction of 40-45%.

What is the most appropriate initial treatment?

Select the SINGLE most appropriate option from the list below. Select ONE option only.