Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents for follow-up of known moderate aortic stenosis. Currently reports [asymptomatic / exertional dyspnea / atypical chest pain / lightheadedness]. Denies syncope, orthopnea, or paroxysmal nocturnal dyspnea. Functional capacity is estimated at [X] METs. No recent hospitalizations for heart failure.
Clinical Examination Findings
Cardiovascular exam reveals a regular rate and rhythm. Carotid upstroke is [normal/brisk]. Cardiac auscultation demonstrates a grade [II-III/VI] harsh, crescendo-decrescendo systolic ejection murmur heard best at the right upper sternal border, radiating to the carotids. S1 is normal; S2 is [intact/soft]. No diastolic murmurs or gallops. Peripheral pulses are symmetric. No peripheral edema noted.
Treatment Protocol
Plan: Continue clinical surveillance with serial echocardiography every [6-12] months. Strict blood pressure control targeting <130/80 mmHg. Advise patient to avoid strenuous isometric exercise. Monitor for development of symptoms (angina, syncope, dyspnea). If symptoms develop or LVEF declines <50%, consider referral for surgical or transcatheter aortic valve replacement (SAVR/TAVR).