Practice Test Geeks(CCS) Certified Cardiovascular Specialist Practice Test
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Clinical Procedures & Protocols Flashcards

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

Read the first 7 Clinical Procedures & Protocols flashcards as text

  1. During a diagnostic right heart catheterization, the pulmonary capillary wedge pressure (PCWP) is obtained by inflating the balloon on the Swan-Ganz catheter. What does an elevated PCWP (>18 mmHg) most directly reflect?

    Answer: Left ventricular end-diastolic pressure

    PCWP approximates left atrial pressure and thus left ventricular end-diastolic pressure, making it a key indicator of left-sided filling pressures.

  2. A patient undergoing coronary angiography develops contrast-induced nephropathy (CIN). Which pre-procedural intervention has the strongest evidence for reducing this risk?

    Answer: Isotonic saline hydration

    Adequate pre- and post-procedural isotonic saline hydration remains the most evidence-based strategy for preventing contrast-induced nephropathy.

  3. When performing a transesophageal echocardiogram (TEE) to evaluate a prosthetic mitral valve, which view best demonstrates the subvalvular apparatus and leaflet motion?

    Answer: Transgastric long-axis view

    The transgastric long-axis view provides the best alignment for Doppler interrogation and visualization of the subvalvular apparatus of the mitral valve.

  4. A 58-year-old patient with known coronary artery disease is scheduled for elective noncardiac surgery. His resting ECG shows a left bundle branch block (LBBB). Which stress test modality is most appropriate?

    Answer: Adenosine nuclear perfusion imaging

    Pharmacologic vasodilator stress (adenosine or regadenoson) with nuclear imaging is preferred in LBBB because exercise-induced septal perfusion defects can be false-positive.

  5. After successful primary PCI for STEMI, a patient develops cardiogenic shock refractory to vasopressors. Which mechanical circulatory support device provides the greatest reduction in left ventricular workload?

    Answer: Veno-arterial ECMO (VA-ECMO)

    VA-ECMO provides the highest level of hemodynamic support and cardiac output augmentation in refractory cardiogenic shock, though it does not directly unload the LV.

  6. During electrophysiology study, what maneuver is used to differentiate AVNRT from AVRT?

    Answer: His-refractory premature ventricular complex (PVC) during tachycardia

    A His-refractory PVC that advances or terminates the tachycardia proves accessory pathway involvement (AVRT), as the AV node is bypassed.

  7. A patient with severe symptomatic aortic stenosis (AVA 0.7 cm², mean gradient 52 mmHg) is deemed high surgical risk. What is the most appropriate next intervention?

    Answer: Transcatheter aortic valve replacement (TAVR)

    TAVR is indicated for patients with severe symptomatic aortic stenosis who are at high or prohibitive surgical risk per current ACC/AHA guidelines.