A 74-year-old man presented to clinic with a complaint of numerous episodes of dizziness, and has lost consciousness. Patient History: Hypertension and DJD, for which he takes amlodipine and acetaminophen. Examination: Supine blood pressure is 142/84 mmHg and heart rate is 80 beats/minute and regular. Standing, his blood pressure is 140/82 and heart rate is at 88 beats/minute. Cardiovascular examination is remarkable for a slightly delayed carotid upstroke, and a 2/6 systolic ejection murmur at the left sternal border, without gallop.
There is no jugular venous distension, and there are no carotid bruits. Which next steps is the most appropriate for this patient’s evaluation? (Answer is posted in the comment section below!) *This case is from the Editorial team of Docplexus and is meant for educative purposes only. Source: The PassMachine
