American Board of Internal Medicine (ABIM) Certification Practice Exam

How should patients with new-onset heart failure and multiple risk factors be evaluated?

1. Only by physical examination

2. By stress testing or cardiac catheterization

3. With echocardiograms exclusively

4. Through lifestyle assessments

The correct answer is: By stress testing or cardiac catheterization

Patients with new-onset heart failure and multiple risk factors warrant comprehensive evaluation strategies to better understand the underlying causes and to develop an appropriate management plan. Stress testing or cardiac catheterization is critical in this context as these methods help assess the cardiac function and determine the presence of coronary artery disease, ischemia, or other cardiac abnormalities. Stress testing can provide insight into the functional capacity of the heart and identify any arrhythmias or cardiac ischemia that may not be evident at rest. Similarly, cardiac catheterization allows for direct visualization of the coronary arteries, helping to diagnose significant blockages or other structural heart disease that may contribute to the development of heart failure. Physical examinations alone are insufficient when multiple risk factors are present, as they do not provide details regarding the heart’s structure and function. Relying exclusively on echocardiograms could lead to missed diagnoses, as they may not fully assess the functional capacity or provide information on ischemia. Lifestyle assessments, while important in overall management, wouldn't provide the critical data needed for diagnosing the specific cause of heart failure. Thus, utilizing stress testing or cardiac catheterization in the evaluation process addresses the comprehensive assessment needed for properly formulating a diagnosis and creating a targeted treatment plan in patients with new-onset heart failure and