A 52-year-old male presents for a routine physical examination, which reveals a III/VI systolic ejection murmur with a systolic ejection click and a soft S2 heart sound. He has no dyspnea or chest pains and has never had a syncopal episode. Echocardiography reveals aortic stenosis with a mean pressure gradient of 35 mm Hg with an aortic valve area of 1.2 cm2. The aortic root was measured at 5.2 cm.
Which of the following is the most likely etiology?
A. Senile calcific degeneration
B. Bicuspid aortic valve
C. Rheumatic valvular disease
D. Fabry’s disease