Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with [exertional dyspnea/fatigue/syncope]. Symptoms are progressive, associated with [chest pain/palpitations]. No history of rheumatic fever or congenital heart disease syndromes. Functional capacity is [NYHA Class I-IV].
Clinical Examination Findings
Cardiovascular exam reveals a harsh systolic ejection murmur at the left upper sternal border, radiating to the left shoulder. Possible thrill palpable at the pulmonic area. S2 is [split/soft/absent]. Jugular venous distention (JVD) and hepatomegaly noted if right heart failure is present.
Treatment Protocol
Management plan: 1. Serial echocardiography to monitor peak/mean pressure gradients. 2. If symptomatic or severe (peak gradient >64 mmHg), consider Balloon Pulmonary Valvuloplasty (BPV). 3. Surgical valvotomy or valve replacement for complex anatomy. 4. Prophylaxis for infective endocarditis if indicated.