Review Question - QID 214533

A 33-year-old man presents to his primary care physician for syncope. The patient reports that while playing soccer he felt lightheaded and subsequently fainted. He woke up immediately and denied feeling confused following the syncopal episode. He has a history of hypertension that is being managed with diet and exercise and he smokes 1 pack of cigarettes per week. He reports that his paternal uncle suddenly died when he was 35 due to "a heart problem." His blood pressure is 145/105 mmHg, pulse is 76/min, and respirations are 16/min. Cardiac auscultation demonstrates a 2/6 midsystolic murmur that is best heard in the left sternal border and is increased with Valsalva maneuvers. An electrocardiogram demonstrates prominent Q waves in the inferior and lateral leads along with left axis deviation. An echocardiogram demonstrates a left ventricular wall thickness of 15 mm at the basal anterior septum and systolic anterior motion of the mitral valve. Which of the following is the most appropriate next step in management?