Cardiology: severe aortic stenosis: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Cardiology: severe aortic stenosis

Sample item

A 68-year-old man has exertional syncope and angina, an ejection systolic murmur radiating to the carotids, a slow-rising pulse and a soft second heart sound. Which intervention improves survival once he is symptomatic?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

A. Aortic valve replacement

Symptoms of angina, syncope or heart failure in severe aortic stenosis carry a poor prognosis without valve replacement, with average survival of only 2 to 3 years. Surgical or transcatheter replacement is the only therapy that improves outcome. Vasodilators can cause dangerous hypotension.

Option by option

  • A. Aortic valve replacement (correct)

    Correct. Valve replacement is the only life-prolonging treatment for symptomatic severe AS.

  • B. High-dose vasodilator therapy

    Vasodilators lower afterload in a fixed obstruction and can precipitate syncope.

  • C. Beta-blocker therapy

    Beta-blockers do not alter the course and may reduce cardiac output.

  • D. Diuretic therapy alone

    Diuretics only relieve congestion and do not change prognosis.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Medicine questions

Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is A, Aortic valve replacement. Symptoms of angina, syncope or heart failure in severe aortic stenosis carry a poor prognosis without valve replacement, with average survival of only 2 to 3 years.

Why is "High-dose vasodilator therapy" not the answer?

Vasodilators lower afterload in a fixed obstruction and can precipitate syncope.

Why is "Beta-blocker therapy" not the answer?

Beta-blockers do not alter the course and may reduce cardiac output.

Why is "Diuretic therapy alone" not the answer?

Diuretics only relieve congestion and do not change prognosis.

What concept does this question test?

It tests Cardiology: severe aortic stenosis in General Medicine. Surgical or transcatheter replacement is the only therapy that improves outcome. Vasodilators can cause dangerous hypotension.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cardiology: severe aortic stenosis?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.