American Board of Internal Medicine (ABIM) Certification Practice Exam

What is the most common defect associated with coarctation of the aorta?

1. Mitral valve prolapse

2. Bicuspid aortic valve

3. Tricuspid valve insufficiency

4. Atrial septal defect

The correct answer is: Bicuspid aortic valve

The defect most commonly associated with coarctation of the aorta is a bicuspid aortic valve. This association is significant because both coarctation of the aorta and bicuspid aortic valve are congenital heart defects that share a similar embryological origin. The bicuspid aortic valve is characterized by the presence of only two cusps instead of the normal three, which can lead to aortic stenosis or regurgitation over time. In the context of coarctation of the aorta, the presence of a bicuspid aortic valve is clinically relevant, as it can predispose individuals to additional cardiovascular complications. For instance, patients may experience issues such as hypertension due to the increased afterload and lower blood flow past the coarctation site. Other options presented in the question do not have the same strong association with coarctation of the aorta. Mitral valve prolapse, tricuspid valve insufficiency, and atrial septal defects are more commonly seen in different pathological contexts and are not directly linked to the presence of coarctation of the aorta as is the case with the bicuspid aortic valve.