Case study ( 4021 views as of January 16, 2019 )
Brian is a 67-year-old recently retired heavy duty mechanic. He was told he had a “heart murmur” as a child but has suffered no other serious illness or operations in the past. He recently noticed breathlessness when walking his dog, initially only up hills, but now on the flat. Brian recently put on weight after having stopped smoking after 35 years but he is otherwise well.
On examination with his family doctor, Brian's blood pressure is 137/80 mmHg with a heart rate of 72 bpm. His body mass index (BMI) is 32. On detailed questioning, Brian also notes some chest discomfort and lightheadedness while rushing. His only medication is an antacid and some recently prescribed inhalers, but with little symptomatic relief. His family doctor confirms he has a heart murmur, and Brian is referred for an echocardiogram.
Brian's echocardiogram shows normal heart function but a narrowed aortic valve. Cardiac catheterization confirms severe aortic stenosis, and normal coronary arteries. Brian is referred to a cardiac surgeon for elective heart surgery to replace his narrowed aortic valve. It is also recommended to Brian to see a dentist before surgery and a dietitian to help him improve his diet and weight loss efforts.Author: Dr. Stephen Fort