Cardiovascular Disease Blueprint

ardiovascular Disease Blueprint

Certification Examination (CERT)

Blueprint for the Full-Day, Multiple-Choice Questions Component of the Exam:

Purpose of the exam

The exam is designed to evaluate the knowledge, diagnostic reasoning, and clinical judgment

skills expected of the certified cardiovascular disease specialist in the broad domain of the

discipline. The ability to make appropriate diagnostic and management decisions that have

important consequences for patients will be assessed. The exam may require recognition of

common as well as rare clinical problems for which patients may consult a certified

cardiovascular disease specialist.

Exam content

Exam content is determined by a pre-established blueprint, or table of specifications. The

blueprint is developed by ABIM and is reviewed annually and updated as needed for currency.

Trainees, training program directors, and certified practitioners in the discipline are surveyed

periodically to provide feedback and inform the blueprinting process.

The primary medical content categories of the blueprint are shown below, with the percentage

assigned to each for a typical exam:

Medical Content Category

% of Exam

Arrhythmias

15%

Coronary Artery Disease 21.5%

Heart Failure and Cardiomyopathy 17%

Valvular Disease

15%

Pericardial Disease 4%

Congenital Heart Disease

Vascular Diseases 6%

Systemic Hypertension and Hypotension 7.5%

Pulmonary Circulation Disorders 3%

Systemic Disorders Affecting the Circulatory System 4%

Normal Cardiovascular Anatomy and Physiology 2%

100%

Exam questions in the content areas above may also address clinical topics in:

• Preventive and rehabilitative cardiology

• Cardiovascular disease in women

• Geriatric cardiovascular disease

• Preoperative assessment for noncardiac surgery

• Postoperative cardiac care

• Critical care medicine, cardiovascular surgery, and general internal medicine as

encountered in the practice of cardiology (including some general pediatrics with an

emphasis on adolescent medicine)

ABIM is committed to working toward health equity and believes that board-certified physicians

should have an understanding of health care disparities. Therefore, health equity content that is

clinically important to each discipline will be included in assessments, and the use of gender,

race, and ethnicity identifiers will be re-evaluated.

Exam format

The exam is composed of up to 240 single-best-answer multiple-choice questions, of which

approximately 40 are new questions that do not count in the examinee’s score. Most questions

describe patient scenarios and ask about the work done (that is, tasks performed) by physicians

in the course of practice:

• Making a diagnosis

• Ordering and interpreting results of tests

• Recommending treatment or other patient care

• Assessing risk, determining prognosis, and applying principles from epidemiologic

studies

• Understanding the underlying pathophysiology of disease and basic science knowledge

applicable to patient care

Some questions require interpretation of pictorial material including electrocardiograms,

intracardiac electrograms, hemodynamic recordings, chest radiographs, photomicrographs, and

imaging studies such as coronary angiograms, echocardiograms, ventriculograms, myocardial

perfusion studies, computed tomograms, magnetic resonance images, and intravascular

ultrasound images. Some questions may also require recognition and interpretation of

recorded heart sounds. Learn more information on how exams are developed.

A tutorial including examples of ABIM exam question format can be found at

http://www.abim.org/certification/exam-information/cardiovascular-disease/exam-

tutorial.aspx.

The blueprint can be expanded for additional detail as shown below. Each of the medical

content categories is listed there, and below each major category are the content subsections

and specific topics that may appear in the exam. Please note: actual exam content may vary.

Arrhythmias 15% of Exam

Atrioventricular conduction disease <2%

Atrioventricular block, 1st degree

Atrioventricular block, 2nd degree

Atrioventricular block, complete

Left bundle branch block

Right bundle branch block

Left anterior fascicular block

Left posterior fascicular block

Sinus node dysfunction <2%

Sinus bradycardia

Sinus pauses

Bradycardia-tachycardia syndrome

Supraventricular arrhythmias 2%

Atrioventricular nodal reentrant tachycardia

Pre-excitation syndromes (including Wolff-Parkinson-White)

Atrioventricular reciprocating tachycardia

Ventricular arrhythmias 2%

Ventricular tachycardia, monomorphic

Ventricular tachycardia, polymorphic

With prolonged Q-T interval

Without prolonged Q-T interval

Ventricular fibrillation (including idiopathic and

non-idiopathic varieties)

Premature ventricular complexes

Atrial arrhythmias 3.5%

Atrial fibrillation

Atrial flutter

Atrial tachycardia

Ectopic atrial rhythms

Premature atrial contractions

Channelopathies <2%

Long Q-T, congenital or acquired

Brugada syndrome

Early repolarization

Sudden cardiac death <2%

Syncope <2%

Pacemaker and ICD function <2%

Antiarrhythmic drug effects <2%

Coronary Artery Disease 21.5% of Exam

Angina pectoris 5%

Unstable angina

Vasospastic angina

Angina equivalent

Exertional angina

Angina with microvascular disease

Chronic ischemic heart disease 5%

Coronary atherosclerosis

Remote myocardial infarction

Aneurysm of the heart

Coronary artery aneurysm

Silent myocardial ischemia

Acute myocardial infarction 9.5%

STEMI of the anterior wall

STEMI of the inferior wall

Right ventricular involvement

STEMI of the lateral wall

STEMI of the posterior wall (including inferoposterior wall)

Type I Non-STEMI

Type II myocardial infarction

Spontaneous coronary artery dissection

STEMI, other

Early complications following acute myocardial infarction <2%

Ventricular septal rupture

Rupture of the cardiac wall

Rupture of papillary muscle

Postinfarction angina

Postinfarction arrhythmias

Left ventricular pseudoaneurysm

Dynamic left ventricular outflow tract obstruction

Postinfarction systolic heart failure

Atypical angina or noncardiac chest pain <2%

Heart Failure and Cardiomyopathy 17% of Exam

Heart failure 7%

Acute decompensated ventricular failure

Systolic heart failure (heart failure with reduced

ejection fraction)

Diastolic heart failure (heart failure with preserved

ejection fraction)

Heart failure with improved ejection fraction

Cardiogenic shock

Cardiomyopathies 8%

Dilated cardiomyopathies

Hypertrophic cardiomyopathies

Restrictive and infiltrative cardiomyopathies

Chemotherapy-related cardiomyopathy

Stress-induced cardiomyopathy (Takotsubo syndrome)

Myocarditis

Noncompaction cardiomyopathy

Arrhythmogenic right ventricular dysplasia

Transplanted heart <2%

Mechanical circulatory support <2%

Valvular Disease 15% of Exam

Mitral valve disorders 5.5%

Mitral valve regurgitation, native

Mitral valve stenosis, native

Mitral valve prolapse, native

Prosthetic mitral valve

Systolic anterior motion

Aortic valve disorders 4.5%

Aortic valve regurgitation, native

Aortic valve stenosis, native

Prosthetic aortic valve

Tricuspid valve disorders <2%

Tricuspid valve regurgitation, native

Tricuspid valve stenosis, native

Prosthetic tricuspid valve

Pulmonary valve disorders <2%

Pulmonary valve regurgitation, native

Pulmonary valve stenosis, native

Prosthetic pulmonary valve

Endocarditis 2%

Cardiac murmurs and other cardiac sounds <2%

Pericardial Disease 4% of Exam

Acute pericarditis <2%

Chronic pericarditis (including relapsing) <2%

Pericardial constriction and effusion <2%

Pericardial effusion

Cardiac tamponade

Constrictive pericarditis

Effusive-constrictive pericarditis

Abnormalities of the pericardium <2%

Congenital Heart Disease 5% of Exam

Congenital malformations of cardiac chambers and connections <2%

Complete transposition of the great vessels

Corrected transposition of the great vessels

Tricuspid atresia

Anomalous origin or course of coronary artery

Tetralogy of Fallot

Congenital malformations of cardiac septa <2%

Ventricular septal defect

Atrial septal defect

Patent foramen ovale

Atrioventricular septal defect

Congenital malformations of pulmonary and tricuspid valves <2%

Congenital pulmonary valve stenosis

Ebstein anomaly

Congenital malformations of aortic and mitral valves <2%

Other congenital malformations of the heart <2%

Dextrocardia

Congenital heart block

Congenital malformations of the great arteries <2%

Patent ductus arteriosus

Coarctation of the aorta

Aneurysm of the sinus of Valsalva

Congenital malformation of the aortic arch

Pulmonary artery malformation

Congenital malformations of the great veins <2%

Persistent left superior vena cava

Anomalous pulmonary venous connections

Congenital disorders with cardiovascular implications <2%

Eisenmenger syndrome <2%

Vascular Diseases 6% of Exam

Cerebrovascular diseases <2%

Cerebral infarction, including cardiovascular manifestations

Extracranial cervical (carotid and vertebral)

Subclavian steal syndrome with vertebral artery steal

Carotid artery dissection

Diseases of the arteries, arterioles, and capillaries 3%

Peripheral atherosclerosis

Aortic aneurysm and dissection

Raynaud's phenomenon

Thromboangiitis obliterans (Buerger's disease)

Claudication

Acute limb ischemia

Critical limb ischemia

Atheroembolism

Septic arterial embolism

Polyarteritis nodosa

Mucocutaneous lymph node syndrome (Kawasaki disease)

Takayasu arteritis

Giant cell arteritis with polymyalgia rheumatica

Mesenteric arterial insufficiency

Subclavian steal syndrome with internal mammary artery steal

Fibromuscular dysplasia

Diseases of the veins, lymphatic vessels, and lymph nodes <2%

Deep vein thrombosis

Portal vein thrombosis

Iliac vein compression syndrome (May-Thurner syndrome)

Varicose veins of the lower extremities

Chronic venous insufficiency

Chronic idiopathic venous hypertension

Lymphedema

Systemic Hypertension and Hypotension 7.5% of Exam

Hypertensive diseases 7%

Essential (primary) hypertension

Hypertensive heart disease

Hypertensive chronic kidney disease

Severe or resistant hypertension

Urgent/emergent hypertension

Secondary hypertension

Hypertension in pregnancy

Hypotensive diseases <2%

Hypotensive syndrome

Drug-induced hypotension

Pulmonary Circulation Disorders 3% of Exam

Pulmonary embolism <2%

Pulmonary embolism with acute cor pulmonale

Pulmonary embolism without acute cor pulmonale

Chronic pulmonary embolism

Pulmonary hypertension <2%

Pulmonary arterial hypertension (WHO Group 1)

Pulmonary hypertension associated with other diseases

(WHO Groups 2–5)

Systemic Disorders Affecting the Circulatory System 4% of Exam

Musculoskeletal and connective tissue <2%

Systemic lupus erythematosus

Systemic sclerosis

Endocrine, nutritional, metabolic, and hematologic disorders <2%

Dyslipidemias

Diabetes

Obesity

Electrolyte and endocrine abnormalities

Hematologic disorders

Renal disorders <2%

Injury and poisoning <2%

Toxic effects of alcohol

Toxic effects of tobacco and nicotine

Toxic effects of drugs other than alcohol and tobacco

Anaphylactic shock

Angioedema

Cardio-Oncology

<2%

Cardiovascular effects of pharmacological cancer therapy

Cardiovascular effects of radiation therapy

Neoplasms

Malignant neoplasm of the heart and pericardium

Benign neoplasms (including myxoma, fibroma,

and fibroelastoma)

Normal Cardiovascular Anatomy and Physiology 2% of Exam

January 2024

Cardiovascular Disease Blueprint

Certification Examination (CERT)

Blueprint for the Half-Day, Electrocardiograms and Imaging Studies Component of the Exam:

Purpose of the exam

The exam is designed to evaluate the abilities expected of the certified cardiovascular disease

specialist to interpret electrocardiograms and imaging studies. The ability to make appropriate

diagnostic decisions that have important consequences for patients will be assessed. The exam

may require recognition of common as well as rare clinical problems for which patients may

consult a certified cardiovascular disease specialist.

Exam content

Exam content is determined by a pre-established blueprint, or table of specifications. The

blueprint is developed by ABIM and is reviewed annually and updated as needed for currency.

Trainees, training program directors, and certified practitioners in the discipline are surveyed

periodically to provide feedback and inform the blueprinting process.

The content categories of the blueprint are shown below, with the percentage assigned to each

for a typical exam:

Content Category

% of Exam

Electrocardiograms

48%

Echocardiograms

37%

Coronary Angiograms

15%

100%

The exam is composed of up to 75 questions, of which approximately 10 are new questions that

do not count in the examinee’s score. Special question formats are used in this exam, requiring

diagnostic interpretation of electrocardiograms, echocardiograms, and coronary angiograms.

The format comprises a brief patient description and one (or multiple) images. To see examples

of the answer options lists, view the Sample Cases - Electrocardiograms and Imaging Studies.

The interactive exam tutorial and ECG and Imaging Studies tutorial allows you to practice

navigating the answer option lists.

The blueprint can be expanded for additional detail as shown below. Each of the content

categories is listed there, and below each major category are the content subsections and

specific topics that may appear in the exam. Please note: actual exam content may vary.

Electrocardiograms 48% of Exam

General features 2.5 %

P wave abnormalities <2%

Rhythms 10.5%

Atrial rhythms

Atrioventricular junctional rhythms

Ventricular rhythms

Atrioventricular conduction 6%

Abnormal QRS voltage or axis 3%

Ventricular hypertrophy <2%

Intraventricular conduction 4.5%

Myocardial infarction 7.5%

S-T, T, and U wave abnormalities 4.5%

Clinical disorders 5%

Pacemaker function 3%

Echocardiograms 37% of Exam

Left ventricular size, function, and structure 11%

Right ventricular size, function, and structure <2%

Diseases of the atria <2%

Valvular heart disease 11%

Cardiomyopathy 4%

Systemic disease <2%

Pulmonary disease <2%

Diseases of the aorta 2%

Pericardial and pleural diseases 3%

Congenital heart disease <2%

Coronary Angiograms 15% of Exam

Normal <2%

Stenoses 3%

Insignificant stenosis

Moderate stenosis

Severe stenosis

Total occlusion

Filled by collateral vessels <2%

Spasm <2%

Thrombus <2%

Myocardial bridge <2%

Anomalous origin <2%

Fistula <2%

Aneurysm <2%

Bypass graft <2%

Dissection <2%

Stents <2%

Patent stent

Occluded stent

January 2024