American Board of Internal Medicine (ABIM) Certification Practice Exam

In patients with an EF less than 50% and LVESD exceeding 50 mm, how often should they be evaluated?

1. Every 2-3 years

2. Clinical eval every 6-12 months; echo every 6-12 months

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

4. Every month

The correct answer is: Clinical eval every 6-12 months; echo every 6-12 months

The recommended evaluation frequency for patients with an ejection fraction (EF) less than 50% and left ventricular end-systolic dimension (LVESD) exceeding 50 mm is focused on the high risk associated with these parameters. Such patients are considered at greater risk for heart failure progression and other cardiovascular events. Clinical evaluation every 6-12 months allows healthcare providers to closely monitor any changes in the patient's symptoms, functional capacity, and overall health status. This frequent assessment is vital for timely interventions. Additionally, performing an echocardiogram within the same frequency helps in evaluating the left ventricular function and identifying changes that might warrant adjustments in treatment. This combination of clinical and echocardiographic monitoring helps ensure that any deterioration in cardiac function can be detected early and managed appropriately, improving patient outcomes and preventing complications. In contrast, longer intervals or less frequent evaluations would not be sufficient given the heightened risk associated with the stated echocardiographic findings. Regular monitoring is critical for effective management in this patient population.