Practice Test GeeksCSC - Cardiac Subspecialty Certification Exam Practice Test
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Cardiac Subspecialty Flashcards

7 cards from real CSC practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.

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  1. A patient with hypertrophic obstructive cardiomyopathy (HOCM) has a dynamic outflow tract gradient of 55 mmHg at rest. Which maneuver would INCREASE the gradient?

    Answer: Valsalva maneuver (strain phase)

    The Valsalva strain phase reduces venous return, decreasing LV volume and worsening LVOT obstruction in HOCM.

  2. In the PARTNER trial, transcatheter aortic valve replacement (TAVR) compared to surgical AVR showed which key finding in intermediate-risk patients at 2 years?

    Answer: TAVR and SAVR had similar rates of death and disabling stroke

    PARTNER 2A demonstrated non-inferiority of TAVR versus SAVR for the primary endpoint of death or disabling stroke in intermediate-risk patients.

  3. A 65-year-old presents with new-onset atrial fibrillation and a CHA₂DS₂-VASc score of 3. Which anticoagulation strategy is most appropriate?

    Answer: Oral anticoagulation with a DOAC or warfarin

    A CHA₂DS₂-VASc score ≥2 in men (≥3 in women) warrants oral anticoagulation to reduce stroke risk in AF.

  4. On right heart catheterization, a patient has PCWP of 28 mmHg, PA mean of 42 mmHg, and cardiac output of 3.1 L/min. What is the transpulmonary gradient and what does it suggest?

    Answer: TPG = 14 mmHg, suggesting combined pre- and post-capillary pulmonary hypertension

    TPG = mPAP − PCWP = 42 − 28 = 14 mmHg; a TPG >12 mmHg with elevated PCWP indicates combined pre- and post-capillary pulmonary hypertension.

  5. Which echocardiographic finding is most consistent with cardiac tamponade physiology?

    Answer: Right ventricular diastolic collapse and respiratory variation in mitral inflow >25%

    RV diastolic collapse and >25% respiratory variation in mitral inflow velocities are classic echocardiographic signs of tamponade.

  6. A patient with dilated cardiomyopathy (EF 28%) remains symptomatic on maximally tolerated doses of ACE inhibitor and beta-blocker. QRS duration is 162 ms with LBBB morphology. What is the next best step?

    Answer: Refer for cardiac resynchronization therapy with defibrillator (CRT-D)

    CRT-D is a Class I indication in patients with EF ≤35%, LBBB, QRS ≥150 ms, and NYHA class II-IV symptoms despite GDMT.

  7. During exercise stress testing, which hemodynamic response is considered abnormal and associated with increased cardiovascular risk?

    Answer: Failure of systolic blood pressure to rise or a drop of >10 mmHg from baseline

    Exercise-induced hypotension (failure to rise or drop >10 mmHg) indicates severe ischemia or LV dysfunction and is associated with high cardiovascular risk.