Practice Test Geeks(CCS) Certified Cardiovascular Specialist Practice Test
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Treatment Planning & Management 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.

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  1. A patient with dilated cardiomyopathy (EF 22%) develops NYHA Class III symptoms despite maximally tolerated beta-blocker, ACE inhibitor, and MRA. Which agent should be added to further reduce mortality?

    Answer: Sacubitril/valsartan (replacing ACE inhibitor)

    Sacubitril/valsartan (ARNI) reduces CV death and HF hospitalizations more than enalapril alone (PARADIGM-HF) and should replace the ACE inhibitor in eligible symptomatic HFrEF patients.

  2. Which non-pharmacologic intervention has the strongest evidence for improving mortality in patients with obstructive sleep apnea and heart failure?

    Answer: Continuous positive airway pressure (CPAP)

    CPAP treats obstructive sleep apnea, improves EF, reduces sympathetic tone, and lowers blood pressure; ASV is contraindicated in HFrEF due to increased mortality (SERVE-HF).

  3. A patient post-PCI for NSTEMI is on aspirin and ticagrelor. After 12 months of DAPT without bleeding complications, what is the recommended next step?

    Answer: Switch to aspirin alone

    After 12 months of DAPT post-ACS/PCI, current guidelines recommend continued aspirin monotherapy indefinitely unless bleeding risk warrants reassessment.

  4. A patient with severe symptomatic mitral regurgitation (primary, degenerative) has preserved EF of 62% and LVESD of 43 mm. What management is recommended?

    Answer: Mitral valve repair or replacement surgery

    LVESD ≥40 mm in severe primary MR is a Class I indication for mitral valve surgery even with preserved EF, because ventricular dysfunction will progress without repair.

  5. Which drug reduces cardiovascular events in patients with established ASCVD and elevated triglycerides (≥150 mg/dL) despite statin therapy?

    Answer: Icosapentaenoic acid (IPE / Vascepa)

    The REDUCE-IT trial showed that icosapentaenoic acid (Vascepa) 4 g/day significantly reduced ischemic events in statin-treated patients with elevated triglycerides and ASCVD.

  6. A patient with cardiac tamponade shows pulsus paradoxus of 18 mmHg. What is the definitive acute treatment?

    Answer: Emergent pericardiocentesis

    Pericardiocentesis is the definitive treatment for cardiac tamponade; it immediately relieves pericardial pressure and restores cardiac output.

  7. A 45-year-old with hypertrophic cardiomyopathy (non-obstructive) and a first-degree relative who suffered sudden cardiac death is asymptomatic. What is the primary consideration in their management?

    Answer: ICD implantation based on risk stratification

    ICD implantation should be considered in HCM patients with risk factors for SCD, including family history of HCM-related sudden death, using validated risk models (e.g., HCM Risk-SCD).