American Board of Internal Medicine (ABIM) Certification Practice Exam

In the context of severe aortic stenosis, what is the minimum area of the valve (AVA) that indicates severity?

1. ≥1.5 cm2

2. ≤1.0 cm2

3. ≥2.0 cm2

4. ≤2.5 cm2

The correct answer is: ≤1.0 cm2

In the evaluation of aortic stenosis, the aortic valve area (AVA) is a critical measurement used to determine the severity of the condition. An AVA of less than or equal to 1.0 cm² is indicated as the threshold for severe aortic stenosis. This level signifies a significant reduction in the effective cross-sectional area of the valve, leading to increased left ventricular outflow obstruction, elevated pressures, and ultimately placing considerable strain on the heart. In severe cases, patients often present with symptoms such as exertional dyspnea, angina, or syncope, all stemming from the hemodynamic consequences of a severely narrowed aortic valve. Those with an AVA of 1.0 cm² or smaller typically have a worse prognosis and may become candidates for surgical intervention such as aortic valve replacement. The other measurements provided, such as ≥1.5 cm², ≥2.0 cm², and ≤2.5 cm², represent varying states of aortic stenosis that are not classified as severe. An AVA of 1.5 cm² or greater generally indicates mild to moderate aortic stenosis, while an AVA of 2.0 cm² or more suggests a normal functioning