6th May 2025

Mr Y is a 64-year-old man with a murmur found after presenting to his GP with chest pain, reproducible on exertion at approximately 300m on the flat.

Mr Y is a 64-year-old man with a murmur found after presenting to his GP with chest pain, reproducible on exertion at approximately 300m on the flat. He is an ex-smoker and is on lisinopril for hypertension. His blood pressure in clinic is 125/75. His GP sends him for an echocardiogram to ascertain the source of the murmur which demonstrates mitral regurgitation of moderate severity and no other significant valve disease with a left ventricular ejection fraction of 57% by biplane. 

What is the next best step for him?

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