American Board of Internal Medicine (ABIM) Certification Practice Exam

For moderate aortic stenosis, how frequently should clinical evaluation and echocardiography be performed?

1. Every 6-12 months

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

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

4. Every month

The correct answer is: Clinical eval yearly; echo every 1-2 years

For a patient with moderate aortic stenosis, the recommendation is to perform a clinical evaluation annually and echocardiography every 1 to 2 years. This approach ensures that healthcare providers can closely monitor the progression of the condition and make timely decisions regarding management, particularly since moderate aortic stenosis can progress to severe aortic stenosis, which may require surgical intervention. Regular clinical evaluations allow for the assessment of symptoms, such as exertional dyspnea or angina, which are critical for understanding the patient's functional status and need for potential interventions. The echocardiography serves to monitor the hemodynamics of the heart and quantify the aortic valve area over time, providing insight into whether surgical considerations should be taken. The frequency of assessments outlined here balances the need for careful monitoring of the condition while avoiding unnecessary repetitive testing. In contrast, more frequent assessments, such as every 6-12 months or every month, would likely result in excessive healthcare utilization and do not align with evidence-based guidelines. Similarly, less frequent evaluations, like every 3-5 years, would not adequately capture the potential changes associated with aortic stenosis in a moderate stage.