Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive exertional dyspnea (NYHA class [I-IV]), orthopnea, and paroxysmal nocturnal dyspnea. Reports symptoms of palpitations, angina pectoris, or lightheadedness. Duration of symptoms: [Timeframe]. No history of syncope or overt heart failure decompensation.
Clinical Examination Findings
Vitals: Wide pulse pressure noted. Cardiovascular: Hyperdynamic precordium, displaced apical impulse (left and downward). Auscultation: Decrescendo diastolic murmur (grade [1-6]/6) heard best at the left sternal border. Presence of Austin Flint murmur. Peripheral: Corrigan’s pulse, de Musset’s sign, and Duroziez’s sign present. Lungs: Clear to auscultation or bibasilar crackles.
Treatment Protocol
Initiate guideline-directed medical therapy (GDMT) including ACE inhibitors/ARBs. Monitor for surgical intervention (AVR) based on LVEF <50% or symptoms. Strict blood pressure control. Serial echocardiographic surveillance every [6-12] months.