A 43-Year-Old Man Comes to the Physician for Evaluation of a Headache

A 43-year-old man comes to the physician for evaluation of a headache that he has had for the past 6 months. The patient reports that nothing helps to relieve the headache and that it is more severe in the morning. During the past 2 months, he has been unable to maintain an erection and he has had decreased sexual desire. There is no personal or family history of serious illness. His temperature is 37.0°C (98.6°F) , pulse is 80/min, and blood pressure is 150/90 mm Hg. Examination shows an enlarged nose, forehead, and jaw and widened hands, fingers, and feet. His hands are sweaty. His serum glucose concentration is 260 mg/dL. Which of the following is most likely to be associated with this patient's condition?

A) Aortic root dilation
B) Bicuspid aortic valve
C) Left ventricular hypertrophy
D) Mitral valve prolapse
E) Pericardial effusion