A 68-year-old man is referred for assessment of an ejection systolic murmur after presenting with worsening breathlessness. Image loops taken from his transthoracic echocardiogram are shown
The following measurements were obtained during transthoracic echo:
Coronary angiography demonstrated mild atheroma without any significant disease.
Which one of the following would be the most useful next investigation?
A. Repeat transthoracic echocardiogram in 6 monthsThis patient has a small aortic valve area and a modest peak gradient in the context of LV impairment (low flow, low gradient AS). In this subset of individuals low-dose dobutamine stress echocardiography can help to distinguish truly severe AS from pseudo-severe AS.