MRCP2-0199
A 55-year-old woman presents for a routine check-up and is found to have a systolic murmur. Further investigation with a transthoracic echocardiogram reveals severe primary mitral regurgitation and a left ventricular ejection fraction of 55%, with no significant pathology in other valves. She denies any symptoms such as shortness of breath, reduced exercise tolerance or chest pain. She has a past medical history of well-controlled asthma, post-partum depression and a tibial fracture one year ago. She uses a salbutamol inhaler but takes no other regular medications. What is the most appropriate management plan?