American Board of Internal Medicine (ABIM) Certification Practice Exam

What is often a symptom indicating the need for aortic valve replacement?

1. Chest pain

2. Palpitations

3. Symptoms of heart failure

4. Dizziness upon standing

The correct answer is: Symptoms of heart failure

Aortic valve replacement is typically indicated when patients exhibit symptoms of heart failure, which can result from aortic stenosis or regurgitation. These symptoms may include shortness of breath, fatigue, and fluid retention, all of which indicate that the heart is struggling to pump effectively due to the compromised valve function. In cases of severe aortic valve disease, heart failure develops as the left ventricle adapts to the increased workload, but over time, this leads to decreased cardiac output and symptoms consistent with heart failure. Recognizing these signs is crucial for timely intervention, as untreated severe aortic stenosis can lead to significant morbidity and mortality. While chest pain, palpitations, and dizziness upon standing may occur in patients with aortic valve issues, they are not as definitive for the need for replacement as the symptoms of heart failure. Symptoms like fatigue and exertional dyspnea specifically point towards the inability of the heart to maintain adequate circulation, making heart failure symptoms the most indicative for the necessity of surgical intervention.