A 71-year-old female was scheduled to undergo an elective total hip arthroplasty. Her activity level is minimal due to arthritic changes of her hips. She has a history of hypertension and hypothyroidism, both under good control with medication. Prior to her surgery, a systolic murmur was appreciated, prompting a full cardiac workup. A transthoracic echocardiogram revealed aortic stenosis with a peak gradient across the aortic valve of 48 mm Hg and a left ventricular ejection fraction of 35% with concentric hypertrophy. No evidence of stress-induced ischemia was appreciated on a dobutamine stress test.