American Board of Internal Medicine (ABIM) Certification Practice Exam

What do guidelines recommend for follow-up in patients with aortic regurgitation and preserved left ventricular function?

1. Every 1-2 years evaluation

2. Every 6-12 months evaluation

3. Echo only as needed

4. Evaluation based on functional capacity

The correct answer is: Every 6-12 months evaluation

For patients with aortic regurgitation who have preserved left ventricular function, guidelines typically recommend evaluation every 6-12 months. This recommendation is grounded in the need for regular monitoring of the condition, as aortic regurgitation can progress over time, potentially leading to left ventricular dilation and dysfunction. Evaluating patients at this frequency allows for timely assessment of changes in left ventricular size and function, which are crucial for determining the appropriate timing for surgical intervention, should it be necessary. This proactive approach helps to ensure that any deterioration in cardiac function is addressed before it leads to complications, such as heart failure. In contrast, evaluation every 1-2 years may not be sufficient for patients whose condition could change more rapidly than that timeframe allows. Relying solely on echocardiography as needed does not provide a consistent monitoring strategy and could lead to missed opportunities for early intervention. Lastly, evaluation based on functional capacity, while important, does not replace the need for regular imaging to assess structural changes in the heart associated with the progression of aortic regurgitation. Regular echocardiographic evaluations are structured to provide a comprehensive view of both function and structure, which is vital for patient management in this condition.