American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended frequency for echocardiographic surveillance in mild aortic regurgitation?

1. Every 6-12 months

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

3. Every 1-2 years

4. As needed based on symptoms

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

In mild aortic regurgitation, the recommended approach for echocardiographic surveillance typically includes a yearly clinical evaluation and echocardiograms every 3 to 5 years. This strategy allows for effective monitoring of potential disease progression while avoiding unnecessary imaging for patients who are stable and whose condition is unlikely to change rapidly. The reason for this specific frequency is that mild aortic regurgitation often does not lead to significant symptoms or hemodynamic changes in the short term. Regular clinical evaluations help assess any emerging symptoms and monitor blood pressure, heart rate, and overall clinical status. Echocardiograms at intervals of 3 to 5 years are adequate for evaluating any changes in the severity of the regurgitation or the left ventricular function, as significant changes typically occur over a longer duration. Thus, this recommendation balances the need for surveillance with the recognition that most patients with mild aortic regurgitation can remain stable for several years without immediate intervention, making over-monitoring less necessary.