American Board of Internal Medicine (ABIM) Certification Practice Exam

How often should patients with an EF greater than or equal to 50% and LVESD less than or equal to 50 mm undergo echocardiographic surveillance?

1. Every 2-3 years

2. Every 6-12 months

3. Yearly clinical evaluation; echo every 3-5 years

4. Monthly evaluations

The correct answer is: Every 6-12 months

Patients with an ejection fraction (EF) greater than or equal to 50% and a left ventricular end-systolic diameter (LVESD) of 50 mm or less are generally considered to be in a stable condition concerning their heart function, particularly regarding the risk of heart failure. The recommended surveillance for these patients aims to monitor any changes that might indicate a deterioration in their cardiac status. Regular echocardiographic surveillance every 6 to 12 months is appropriate as it allows for timely detection of any significant changes in cardiac function or structure that could necessitate clinical intervention. This interval reflects a balance between adequately monitoring patient status and avoiding unnecessary testing for those who are stable. Though yearly evaluations and longer intervals are sometimes seen in stable patients, the recommendation to perform echocardiograms more frequently (every 6-12 months) allows healthcare providers to catch potential issues early in this population, ensuring proactive management. More frequent evaluations, such as monthly, would be impractical and burdensome for patients without showing a clear benefit, while extending surveillance intervals beyond a year might risk missing critical developments in heart function.