robin082006
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A 50-year-old male comes for his routine medical check up. He is in good state of health and his past medical history is insignificant. His pulse is 79/min and BP is 130/70 mmHg. Examination of precordium reveals sustained heaving of the apical impulse. On cardiac auscultation, a high-pitched, harsh, II/VI ejection systolic murmur is noted which is best heard at the second right intercostal space and it radiates to the neck. Chest X-ray reveals a normal sized heart and clear lung fields. EKG shows left ventricular hypertrophy with a strain pattern. Echocardiography confirms the presence of a moderate degree of aortic stenosis. Which of the following is the most appropriate next step in the management of this patient?
A. Reassurance that his disease is benign
B. Avoidance of strenuous physical activity
C. Information about infective endocarditis prophylaxis and regular follow ups
D. Use of cardiac glycosides and diuretics
E. Referral for coronary angiography and cardiac surgery
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| mjl1717
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Good question:
I like answer-b- avoid stenuous activity
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| me007
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C - follow ups?
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| sarika
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c prophylaxis
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| Guptashutosh
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C
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| aml
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c or e
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| Aashi
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The answer is C---->rest everythin in the choice will be an advice to the patient once he gets SYMPTOMATIC, except ofcourse NOT reassurance,this is NEVER in the package of ur list of advices......He is ASYMPTOMATIC ,but he is got clinically and radiologically evident A.S-->its an indication for prophylaxis for endocarditis,and regular follow ups-->this is the advice he needs as of now....
GL
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| robin082006
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answer is C, good explanantion Aashi
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