1. A 70-year-old man with a history of hypertension presents with progressive exertional dyspnea and angina. Physical examination reveals a harsh systolic murmur best heard at the right upper sternal border. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
2. A 65-year-old woman with severe aortic stenosis presents with syncope during exercise. Echocardiography reveals a peak aortic valve gradient of 80 mmHg and a left ventricular ejection fraction of 50%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
3. A 75-year-old man with severe aortic stenosis presents with progressive dyspnea, orthopnea, and lower extremity edema. Echocardiography reveals a peak aortic valve gradient of 60 mmHg and a left ventricular ejection fraction of 30%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
4. A 60-year-old man with a history of bicuspid aortic valve presents with progressive exertional dyspnea and angina. Echocardiography reveals severe aortic stenosis with a peak gradient of 70 mmHg and a left ventricular ejection fraction of 45%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
5. A 75-year-old woman with severe aortic stenosis presents with syncope and hypotension. Echocardiography reveals a peak aortic valve gradient of 80 mmHg and a left ventricular ejection fraction of 35%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
6. A 65-year-old man with a history of hypertension and diabetes presents with progressive dyspnea and chest pain. Echocardiography reveals severe aortic stenosis with a peak gradient of 60 mmHg and a left ventricular ejection fraction of 50%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
7. A 80-year-old woman with severe aortic stenosis presents with recurrent episodes of syncope. Echocardiography reveals a peak aortic valve gradient of 80 mmHg and a left ventricular ejection fraction of 40%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
8. A 75-year-old man with a history of coronary artery disease and severe aortic stenosis presents with progressive dyspnea and angina. Echocardiography reveals a peak aortic valve gradient of 70 mmHg and a left ventricular ejection fraction of 35%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
9. A 65-year-old woman with severe aortic stenosis presents with progressive dyspnea and chest pain. Echocardiography reveals a peak aortic valve gradient of 80 mmHg and a left ventricular ejection fraction of 45%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
10. A 75-year-old man with severe aortic stenosis presents with syncope and hypotension. Echocardiography reveals a peak aortic valve gradient of 90 mmHg and a left ventricular ejection fraction of 30%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
11. A 60-year-old woman with a history of bicuspid aortic valve presents with progressive exertional dyspnea and angina. Echocardiography reveals severe aortic stenosis with a peak gradient of 75 mmHg and a left ventricular ejection fraction of 40%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
12. A 70-year-old man with severe aortic stenosis presents with recurrent episodes of syncope and hypotension. Echocardiography reveals a peak aortic valve gradient of 85 mmHg and a left ventricular ejection fraction of 35%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement
13. A 75-year-old woman with a history of coronary artery disease and severe aortic stenosis presents with progressive dyspnea and chest pain. Echocardiography reveals a peak aortic valve gradient of 75 mmHg and a left ventricular ejection fraction of 40%. Which of the following is the most appropriate next step in management?
A. Initiate medical therapy with diuretics and vasodilators
B. Perform stress echocardiography
C. Perform cardiac catheterization
D. Recommend transcatheter aortic valve replacement (TAVR)
E. Recommend surgical aortic valve replacement