BOF 85

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BOF: 85

A 70 year old male presents with syncope. There is no significant past history. On examination you note that he has a slow rising pulse, BP 90/60, JVP not elevated, apex beat 5^th left intercostal space just lateral to the mid-clavicular line heaving in nature. The second heart sound in soft and there is a harsh ejection systolic murmur at the aortic area and the murmur radiates to the neck.

In this patient which one of the following would be an indication for valve replacement?

a)      Syncope

b)      BP 90/60

c)      Square area of valve 1.6 cms²

d)     p mitrale

e)      left ventricular hypertrophy on ECG

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