AR Surveillance Intervals — EECC MCQ

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EasyValvular Heart DiseaseAR Surveillance IntervalsEECC

A 55-year-old man with known mild aortic regurgitation has routine echocardiography. The vena contracta is measured at 3 mm and the regurgitant volume at 25 mL. His LV dimensions are normal and LVEF is 60%. How should he be followed up?

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Correct answer: D — Use clinical and echo surveillance every 2–3 years

The 2025 ESC/EACTS VHD Guidelines recommend surveillance intervals based on severity and LV response. For mild AR with normal LV dimensions and function: clinical review and echocardiography every 2-3 years. For moderate AR: annually. For severe AR with normal LV function within intervention thresholds: 6-monthly to detect early LV dilatation or dysfunction. AR severity grading: mild (vena contracta <3 mm, RVol <30 mL, RF <30%), moderate (VC 3-6 mm, RVol 30-59 mL, RF 30-49%), severe (VC ≥6 mm, RVol ≥60 mL, RF ≥50%). More frequent monitoring is appropriate if there is any change in symptoms or LV parameters trending toward intervention thresholds.

Reference: ESC/EACTS (2025): Guidelines for the Management of Valvular Heart Disease: https://www.nice.org.uk/guidance/ng109/chapter/recommendations