American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the recommended follow-up for mild aortic stenosis, with a Vmax of 2.0-2.9 m/s?

1. Clinical eval yearly; echo every 1-2 years

2. Clinical eval biannually; echo every 3-5 years

3. Clinical eval yearly; echo every 3-5 years

4. Clinical eval every month

The correct answer is: Clinical eval yearly; echo every 3-5 years

The recommended follow-up for mild aortic stenosis, characterized by a peak aortic jet velocity (Vmax) of 2.0-2.9 m/s, involves conducting a clinical evaluation yearly and performing echocardiography every 3-5 years. This approach is grounded in evidence-based practice guidelines, which suggest that patients with mild aortic stenosis typically maintain stable hemodynamics and have a lower risk of symptomatic progression compared to more severe forms of the condition. Regular clinical evaluations are important to monitor for potential symptom development, which can signal progression of the disease. Echocardiography is used less frequently (every 3-5 years) for mild cases because significant changes in the severity of the stenosis are less common over short periods. This balance of monitoring helps in identifying changes early, without unnecessary frequent testing, which might not provide additional actionable information for mild aortic stenosis patients. On the other hand, more frequent evaluations, such as a month-to-month check-up, would not be justified due to the typically stable nature of mild stenosis. Similarly, biannual clinical evaluations may overlook gradual symptom changes, and echoing every 1-2 years is excessive for mild cases, as significant changes are less likely