A 78 year old male presents to the emergency room with an episode of syncope. He states he had been walking on a treadmill when he became very dizzy and passed out. He has noted exertional chest pressure in the past, but no dizziness or syncope. His temperature is 37.0, blood pressure 120/80, heart rate 90, and respirations 20. Physical examination reveals normal lung sounds, a III/VI late-peaking systolic murmur best heard at the right upper sternal border radiating to the carotid arteries, a II/VI holosystolic murmur at the cardiac apex, an S4 heart sound, an inaudible S2 heart sound, and a weak and delayed carotid impulse. Laboratory studies are normal. Which of the following is the most appropriate initial treatment based on the above?
B. Aortic valvuloplasty
C. Aortic valve replacement
D. No treatment is needed at this time