3. Exam format
• Exam date: Held once/ year, next one (18th June 2024)
• Exam registration through your national society
• Exam fees (400 Euro)
• 120 MCQ questions over 3 hours
• Delivered using online proctoring platform (ProctorU®).
19. What to focus on in guidelines?
“According to my exam questions”
20. Heart failure guidelines
• HF diagnosis (Most specific, sensitive signs?), algorithm (BNP before ECHO)
• BNP DD (What ↑ or ↓ )
• HF TTT sequencing in different scenarios , indications for iron TTT, CRT,ICD
• Acute heart failure work up and TTT according to hemodynamics
• Hyperkalemia in HF
• HF recovered EF management
• HFpEF diagnosis , role of exercise and TTT (Cutoff point ARNI EF < 57%)
• Heart transplantation/ LVAD indications/ contraindication and complications
• Temporary mechanical support choice (IABP vs ECMO)
• Myocarditis diagnosis (CMR imaging), management
• Amyloidosis types &diagnosis (GLS, CMR), management
21. Valvular guidelines
• Timing of surgery in asymptomatic patients (AS, MS, AR, MR, TR)
• Role of exercise in asymptomatic AS and MS
• Low-gradient AS different scenarios, role of dobutamine/Ca score and management
• TAVR vs. SAVR
• Mitral clip indications
• Multivalvular heart disease (Assessment of severity, limitations of different
parameters)
• Prosthetic valve choice, INR targets, imaging (TTE,TEE,3D)
• Prosthetic dysfunction , and thrombosis management
• Tricuspid valve intervention indications
• Calcific mitral stenosis assessment
• Rheumatic fever diagnosis , prophylaxis and management
22. Endocarditis guidelines
• Which patient need prophylaxis
• Diagnostic criteria (Imaging TTE,TEE) and empirical regimens
• Timing and indications of surgery
• Culture negative endocarditis
• Prognostic factors
• Implantable devices endocarditis
• Special scenarios (CVS, cerebral hge)
• Mimics of endocarditis ( Marantic , libman sac imaging)
23. Aorta & Peripheral guidelines
• Timing of intervention (TAA, AAA) in normal, bicuspid and marfan in
details ( > or ≥ is tricky )
• Aortic dissection diagnosis
• Rupture coronary sinus of Valsalva presentation
• Vasculitis (Takayasu)
• Antiplatelet in TIA, PAD
• Indications for carotid intervention , surgery vs. stent
24. CCS guidelines
• Pretest probability and risk stratification modality choice (CT, MPI,
Dobutamine echo, Invasive?)
• Image interpretation (Dobutamine ECHO, MPI, CMR), MPI artifacts
• Antianginal 1st line, 2nd line, in special scenario ( Low BP, HR, spasm,
bridge, ….)
• Indication for angiography and revascularization (PCI vs, CABG)
• Lead misplacement ECG
25. ACS guidelines
• STEMI equivilant diagnosis (ECGs e.g. wellen , LBBB sgarbossa ,
Dewinter, LM ECG,…..)
• Antiplatelet management in different scenario (High bleeding risk,
perioperative, duration, OAC patints)
• MI complications ( VSR, rupture, arrhythmia ) management
• Time frames for choice of TTT strategy ( PPCI vs pharmacoinvasive)
• MINOCA workup (CMR imaging), Mimics (e.g. Taktsubo diagnosis)
• SCAD imaging (Angio) and management
• Timing and indications of ICD
26. VT&SCD guidelines
• ICD indications in different scenarios
• Long QT diagnosis (ECG) and management
• Catecholenergic polymorphic VT diagnosis (ECG) and management
• Fascicular VT/ RVOT diagnosis (ECG) and management
• PVC management , indication for ablation
• Brugada $ diagnosis (ECG), sports?, and management
• ERP syndrome
• ARVC diagnosis (ECG and CMR), sports?, and management
• Sarcoidosis diagnosis (CMR, PET” Activity) and ICD indications
• Causes and work up for SCD and family screening
• VT storm
• ICD appropriate vs. inappropriate shock (Atrial arrhythmia)
27. SVT & AF guidelines
• 1st option in TTT of….. (Read guidelines algorithms carefully)
• POTS diagnosis and management
• WPW risk stratification and management
• Preexcited AF diagnosis (ECG) and management
• Intracardiac tracing of SVT!
• Proper choice of rhythm control drug in different scenarios
• Indications for AF ablation and complications of PVI
• AF in HF and CRT patients
• Anticoagulation indications (Scores), bleeding management, antidotes
28. Pacing& syncope guidelines
• Heart block ECGs (Mobitz I, II, complete), indications for pacing
• Syncope in elderly vs. falls , 1st investigation
• Bi-fascicular block & syncope management
• Indications of pacing in reflex syncope
• Pacing options in heart failure with AV block
• MRI safety in cardiac electronic devices
• Pacemaker trouble shooting (ECG), complications (short, long term)
• Driving scenarios
29. PHTN &Pulmonary embolism guidelines
• Indications of lytic therapy and percutaneous intervention
• Choice of anticoagulation and regimens
• Indications of IVC filter
• Screening algorithm for CTEPH, risk factors
• PHTN types and defintions (Pre vs. post capillary ) , hemodynamic
tracing
• Risk stratification strata and management of PH (Drug sequencing)
30. GUCH& Pregnancy guidelines
• Indications of VSD, ASD, PDA closure , imaging diagnosis
• Indications of intervention in pulmonary stenosis
• TOF complications , management of pulmonary regurge (Indications)
• Coronary anomalies imaging (MSCT) , role of exercice stress & management
• Fontan and arrhythmia
• Eisenmenger $
• Anticoagulation during pregnancy
• Contraindication of pregnancy in cardiac patients (WHO classes), mode of delivery
• IE prophylaxis
• D.D dilated RV (TEE imaging)
• Management of arrhythmia (Drug safety/DC) &VHD and HTN in pregnancy
31. Perioperative guidelines
• Perioperative drug management (SGLT2i, ACE-I, OAC, antiplatelets,…)
• OAC when to bridge and how
• NOAC management
• Indications for pre-op stress imaging
• Indications for pre-op revascularization
• Asymptomatic valvular heart disease management
32. Cardio-oncology guidelines
• Cardiotoxicity prevention, surveillance , When to hold TTT ?
• Long term FU plan
• ICI & T-CART myocarditis
• Arrhythmia side effects od ibrutinib (AF)
• 5FU coronary spasm
• Radiotherapy
• Cardiac tumors
• Role of PET, CMR in cardiac masses
33. Dyslipidemia& DM& Prevention guidelines
• LDL targets in different subsets
• Non-statin therapy indications
• Statin intolerance management
• Statin in heart failure and hemodialysis patients
• Familial hypercholesterolemia diagnosis, genetic screening
• Lipoprotein a
• Risk stratification SCORE, when to calculate
• Role of ACE-I, aspirin , SGLT2i , Colchicine for 1ry prevention
34. Sports& HCM guidelines
• HCM risk assessment
• HCM imaging (ECHO, CMR)
• ICD indications
• Sports in HCM
• ECG changes in athelete, when to further investigate
• Exercise return post pericarditis and myocarditis in atheletes
• CMR LGE in athelete and management
• Exercise prescription in different valvular , HF, IHD scenarios
35. Pericardial & HTN guidelines
• Pericarditis diagnosis (CMR imaging), TTT regimens and duration
• Chronic, refractory pericarditis
• Pericardial effusion management and timing of FU
• Constrictive pericarditis diagnosis (CMR, hemodynamic tracing),
management
• Cardiac tamponade diagnosis (ECHO, hemodynamic tracing)
• HTN definition, stages, when to treat, combination therapy
• Resistant hypertension workup and management
• Secondary hypertension causes and workup
• HTN emergency workup and management
36. Final tips
• Try to make your own summary for important guidelines
recommendations and tips from EECC & BJCA preparatory courses
• Try to make MCQ key points as bullets in your notebook
• At least 50% of questions contains imaging (TTE,TEE,CMR,CT,PET,MPI),
or ECG which may contains a clue for MCQ, so try to focus on EECC &
BJCA imaging and ECG section