S. is a 59-year-old female who has been followed for several years for aortic

regurgitation. Serial echocardiography has demonstrated normal ventricular function, but the patient was lost to follow-up for the last 16 months and now presents complaining of activity intolerance and weight gain. Physical examination reveals a grade IV/VI diastolic aortic murmur and 2+ lower extremity edema to the midcalf. The AGACNP considers which of the following as the most appropriate management strategy?

A. Serial echocardiography every 6 months    B. Begin a calcium channel antagonist     C. Begin an angiotensin converting enzyme (ACE) inhibitor     D. Surgical consultation and intervention