In asymptomatic patients with mild aortic stenosis, how often should repeat 2D echocardiography be performed for surveillance?

In asymptomatic patients with mild aortic stenosis, how often should repeat 2D echocardiography be performed for surveillance?

• A. Every 1-2 years
• B. Every 6-9 months
• C. Every 3-5 years
• D. Every 10 years

Answer: (C)

In asymptomatic mild aortic stenosis, the goal of surveillance is to catch progression before symptoms or LV dysfunction appear, without subjecting the patient to unnecessary testing. 2D echocardiography tracks the aortic valve area and the mean gradient, and also assesses left ventricular function. Because progression in mild disease is usually slow, repeating the test every few years is sufficient to detect any meaningful change without over-testing. The typical interval is about every 3 to 5 years. If the patient develops symptoms or there are signs of faster progression on imaging, the follow-up interval should be shortened and evaluation occurs sooner. Very frequent testing (every 6-9 months) isn’t needed for mild disease, and waiting many years (such as every 10 years) would risk missing progression.

In asymptomatic mild aortic stenosis, the goal of surveillance is to catch progression before symptoms or LV dysfunction appear, without subjecting the patient to unnecessary testing. 2D echocardiography tracks the aortic valve area and the mean gradient, and also assesses left ventricular function. Because progression in mild disease is usually slow, repeating the test every few years is sufficient to detect any meaningful change without over-testing. The typical interval is about every 3 to 5 years. If the patient develops symptoms or there are signs of faster progression on imaging, the follow-up interval should be shortened and evaluation occurs sooner. Very frequent testing (every 6-9 months) isn’t needed for mild disease, and waiting many years (such as every 10 years) would risk missing progression.