American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended follow-up for mild aortic stenosis with a Vmax of 2.0-2.9 m/s?

1. Clinical evaluation every 6 months

2. Yearly clinical evaluation and echo every 3-5 years

3. Immediate echocardiogram

4. Only clinical evaluation as needed

The correct answer is: Yearly clinical evaluation and echo every 3-5 years

The recommended follow-up for mild aortic stenosis, specifically with a velocity (Vmax) of 2.0-2.9 m/s, is a yearly clinical evaluation accompanied by an echocardiogram every 3-5 years. This approach is based on the understanding that mild aortic stenosis typically has a low risk of progression, but it is essential to monitor the patient regularly for any changes in their condition. Conducting clinical evaluations annually allows healthcare providers to assess any symptoms or signs that could indicate worsening stenosis. Additionally, performing an echocardiogram every 3-5 years provides valuable imaging data to evaluate the progression of aortic stenosis. This helps in determining if and when intervention may be necessary as the patient's condition evolves. The option of conducting clinical evaluations every 6 months may be overly aggressive for mild stenosis, while immediate echocardiograms are unnecessary given the stable nature of this condition. Lastly, only conducting clinical evaluations as needed does not establish a routine follow-up that can effectively catch any progression early, which is important for ensuring patient safety and timely intervention.