American Board of Internal Medicine (ABIM) Certification Practice Exam

For asymptomatic aortic stenosis with a transvalvular velocity of 3-3.9 m/s, how often should echocardiography be performed?

1. q0.5-1y

2. q1-2y

3. q3-5y

4. Every 6 months

The correct answer is: q1-2y

In the case of asymptomatic aortic stenosis with a transvalvular velocity of 3-3.9 m/s, the guideline recommendations for monitoring the condition include performing echocardiography every 1 to 2 years. This frequency is appropriate because it allows for adequate monitoring of the progression of the stenosis, which could potentially lead to symptoms or complications over time. Aortic stenosis can progress, and the transvalvular velocity is an important indicator of the severity of the stenosis. As the velocity increases or if the patient develops symptoms (such as dyspnea, angina, or syncope), more frequent monitoring and potentially intervention may be necessary. The 1 to 2-year interval for echocardiography strikes a balance, ensuring that changes are detected in a timely manner without subjecting the patient to unnecessary imaging. Monitoring every 6 months would be excessive given that the patient is asymptomatic and based on current guidelines, which suggest a more spaced-out schedule for those who do not exhibit any symptoms. Similarly, intervals of 0.5-1 year or 3-5 years would not align with the recommended guidelines, which emphasize a more consistent follow-up within the 1 to 2-year timeframe