NEET SS 2026 • DECEMBER
CARDIOLOGY
Complete High-Yield Practice Book
100 Clinical MCQs with Easy Explanations
Guidelines • Landmark Trials • Clinical Reasoning
Simple language for better understanding
Full vignettes + why each option is right/wrong
ESC 2021/2023 • ACC/AHA 2022 • Key trials
Chapters: HF, ACS, Arrhythmia, Valve, CM, more
Marking: +4 correct –1 incorrect
Feeder Specialty: General Medicine | Target: Cardiology
,NEET SS 2026 Cardiology | Complete Practice Book Easy Explanations
How to Use This Complete Book
This book contains 100 high-yield clinical MCQs written in simple, easy language so you can understand the concepts
clearly. Every question has a patient story, four options, the correct answer, a clear explanation of why it is right, why the
other choices are wrong, and the supporting guideline or famous trial. This is exactly the style of thinking NEET SS tests.
Marking scheme: +4 for correct answer, –1 for incorrect answer. Always try the question first, then read the explanation
carefully. Revise the ‘why’ multiple times. Chapters cover the most important areas of Cardiology for NEET SS.
Chapters in this book
1. Heart Failure (HFrEF, HFpEF, Acute HF, Devices) – Questions 1–30
2. Acute Coronary Syndromes & Stable CAD – Questions 31–50
3. Arrhythmias, Devices & Electrophysiology – Questions 51–70
4. Valvular Heart Disease – Questions 71–85
5. Cardiomyopathies, Myocarditis & Pericardial Disease – Questions 86–95
6. Pulmonary Hypertension, Aorta & Miscellaneous High-Yield – Questions 96–100
Quick Revision Summary at the end
Page 2 • +4 Correct • –1 Incorrect
,NEET SS 2026 Cardiology | Complete Practice Book Easy Explanations
Chapter 1 – Heart Failure (HFrEF, Acute HF, Devices)
Q1
A 58-year-old man with ischemic cardiomyopathy has EF 28% and NYHA III symptoms. He is on full doses of ramipril, carvedilol
and spironolactone. ECG: sinus, LBBB, QRS 158 ms. BP 118/72, HR 68. What is the best next step?
A. Add digoxin
B. Switch ramipril to sacubitril/valsartan (ARNI) and evaluate for CRT-D
C. Add ivabradine
D. Immediate mitral valve clip
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: Patient is still symptomatic on ACEI + BB + MRA. Switch to ARNI (Class I) and he also meets Class I criteria for CRT-D
(EF ≤35%, LBBB, QRS ≥150 ms).
Why others are wrong:
• A – Digoxin has no mortality benefit like ARNI.
• C – Ivabradine only if HR still ≥70 on max BB.
• D – Mitral clip later only if severe MR persists after GDMT + device.
Guideline / Trial: ESC 2021; PARADIGM-HF; MADIT-CRT
Q2
A 64-year-old woman on all 4 pillars (ARNI, bisoprolol, eplerenone, dapagliflozin) has K+ 5.3 and eGFR 48. She wants to continue
MRA. Best plan?
A. Stop eplerenone forever
B. Add potassium binder (patiromer or SZC) and continue eplerenone
C. Switch to spironolactone
D. Reduce dapagliflozin
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: MRAs save lives. Newer potassium binders allow us to keep the MRA safely instead of stopping it permanently.
Why others are wrong:
• A – Permanent stop removes mortality benefit.
• C – Spironolactone raises K+ more.
• D – SGLT2i actually reduce hyperkalemia risk.
Guideline / Trial: ESC 2021/2023; DIAMOND trial
Q3
A 52-year-old man 3 months after anterior STEMI. EF improved from 25% to 38% on full GDMT. QRS 110 ms, NYHA II. About
ICD?
A. Implant ICD now because original EF was 25%
B. No ICD now; reassess after full optimization (EF already >35%)
C. ICD needed because EF <40%
D. Give wearable defibrillator for 3 months
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: Primary prevention ICD needs persistent EF ≤35% after ≥3 months optimal therapy (and ≥40 days post MI). His EF
recovered above the cut-off.
Why others are wrong:
• A – Allow recovery time.
• C – Cut-off is ≤35%.
• D – VEST trial showed no mortality benefit.
Guideline / Trial: ACC/AHA 2022; ESC 2021; DANISH; VEST
Page 3 • +4 Correct • –1 Incorrect
, NEET SS 2026 Cardiology | Complete Practice Book Easy Explanations
Q4
69-year-old man with HFrEF, weight gain 6 kg, congested. Got IV furosemide 40 mg ×2, poor urine output. BP 108/68, warm.
Next diuretic step?
A. Only higher continuous furosemide infusion
B. Add thiazide-type diuretic (metolazone/chlorothiazide) – sequential nephron blockade
C. Immediate ultrafiltration
D. Start dobutamine
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: When loop diuretic response is poor, adding a thiazide-type agent (sequential blockade) improves decongestion.
Supported by ADVOR and CLOROTIC trials.
Why others are wrong:
• A – Continuous infusion not superior (DOSE trial).
• C – Ultrafiltration only after failing medical therapy.
• D – Inotropes only if cold/hypoperfused.
Guideline / Trial: ADVOR; CLOROTIC; DOSE; ESC Acute HF
Q5
47-year-old woman with peripartum cardiomyopathy, EF 34% on 4 pillars, NYHA I, wants future pregnancy. Current advice on
drugs?
A. Continue all 4 drugs in pregnancy
B. Stop ARNI, MRA and SGLT2i before conception; beta-blocker can usually continue
C. Only stop SGLT2i
D. Switch now to hydralazine-nitrate + digoxin
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: ARNI/ACEI/ARB, MRA and SGLT2i are not safe in pregnancy and must be stopped before conception. Beta-blockers
are usually continued with monitoring.
Why others are wrong:
• A – These drugs harm the fetus.
• C – ARNI and MRA also must stop.
• D – Not needed while on effective contraception.
Guideline / Trial: ESC Pregnancy Guidelines 2018; ESC HF 2021
Q6
Diabetic man with HFrEF EF 30% on ARNI + carvedilol + spironolactone. eGFR 42. Can you add SGLT2i?
A. No, eGFR must be >45
B. Yes, dapagliflozin or empagliflozin can be started; benefit persists at this GFR
C. Only canagliflozin allowed
D. Wait till eGFR >60
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: Dapagliflozin and empagliflozin are beneficial in HFrEF down to eGFR ~20–25. Do not delay for perfect kidney
function.
Why others are wrong:
• A – Threshold is lower for HF indication.
• C – Dapa/Empa preferred for HF.
• D – Unnecessary delay.
Guideline / Trial: DAPA-HF; EMPEROR-Reduced; ESC 2021/2023
Page 4 • +4 Correct • –1 Incorrect
CARDIOLOGY
Complete High-Yield Practice Book
100 Clinical MCQs with Easy Explanations
Guidelines • Landmark Trials • Clinical Reasoning
Simple language for better understanding
Full vignettes + why each option is right/wrong
ESC 2021/2023 • ACC/AHA 2022 • Key trials
Chapters: HF, ACS, Arrhythmia, Valve, CM, more
Marking: +4 correct –1 incorrect
Feeder Specialty: General Medicine | Target: Cardiology
,NEET SS 2026 Cardiology | Complete Practice Book Easy Explanations
How to Use This Complete Book
This book contains 100 high-yield clinical MCQs written in simple, easy language so you can understand the concepts
clearly. Every question has a patient story, four options, the correct answer, a clear explanation of why it is right, why the
other choices are wrong, and the supporting guideline or famous trial. This is exactly the style of thinking NEET SS tests.
Marking scheme: +4 for correct answer, –1 for incorrect answer. Always try the question first, then read the explanation
carefully. Revise the ‘why’ multiple times. Chapters cover the most important areas of Cardiology for NEET SS.
Chapters in this book
1. Heart Failure (HFrEF, HFpEF, Acute HF, Devices) – Questions 1–30
2. Acute Coronary Syndromes & Stable CAD – Questions 31–50
3. Arrhythmias, Devices & Electrophysiology – Questions 51–70
4. Valvular Heart Disease – Questions 71–85
5. Cardiomyopathies, Myocarditis & Pericardial Disease – Questions 86–95
6. Pulmonary Hypertension, Aorta & Miscellaneous High-Yield – Questions 96–100
Quick Revision Summary at the end
Page 2 • +4 Correct • –1 Incorrect
,NEET SS 2026 Cardiology | Complete Practice Book Easy Explanations
Chapter 1 – Heart Failure (HFrEF, Acute HF, Devices)
Q1
A 58-year-old man with ischemic cardiomyopathy has EF 28% and NYHA III symptoms. He is on full doses of ramipril, carvedilol
and spironolactone. ECG: sinus, LBBB, QRS 158 ms. BP 118/72, HR 68. What is the best next step?
A. Add digoxin
B. Switch ramipril to sacubitril/valsartan (ARNI) and evaluate for CRT-D
C. Add ivabradine
D. Immediate mitral valve clip
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: Patient is still symptomatic on ACEI + BB + MRA. Switch to ARNI (Class I) and he also meets Class I criteria for CRT-D
(EF ≤35%, LBBB, QRS ≥150 ms).
Why others are wrong:
• A – Digoxin has no mortality benefit like ARNI.
• C – Ivabradine only if HR still ≥70 on max BB.
• D – Mitral clip later only if severe MR persists after GDMT + device.
Guideline / Trial: ESC 2021; PARADIGM-HF; MADIT-CRT
Q2
A 64-year-old woman on all 4 pillars (ARNI, bisoprolol, eplerenone, dapagliflozin) has K+ 5.3 and eGFR 48. She wants to continue
MRA. Best plan?
A. Stop eplerenone forever
B. Add potassium binder (patiromer or SZC) and continue eplerenone
C. Switch to spironolactone
D. Reduce dapagliflozin
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: MRAs save lives. Newer potassium binders allow us to keep the MRA safely instead of stopping it permanently.
Why others are wrong:
• A – Permanent stop removes mortality benefit.
• C – Spironolactone raises K+ more.
• D – SGLT2i actually reduce hyperkalemia risk.
Guideline / Trial: ESC 2021/2023; DIAMOND trial
Q3
A 52-year-old man 3 months after anterior STEMI. EF improved from 25% to 38% on full GDMT. QRS 110 ms, NYHA II. About
ICD?
A. Implant ICD now because original EF was 25%
B. No ICD now; reassess after full optimization (EF already >35%)
C. ICD needed because EF <40%
D. Give wearable defibrillator for 3 months
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: Primary prevention ICD needs persistent EF ≤35% after ≥3 months optimal therapy (and ≥40 days post MI). His EF
recovered above the cut-off.
Why others are wrong:
• A – Allow recovery time.
• C – Cut-off is ≤35%.
• D – VEST trial showed no mortality benefit.
Guideline / Trial: ACC/AHA 2022; ESC 2021; DANISH; VEST
Page 3 • +4 Correct • –1 Incorrect
, NEET SS 2026 Cardiology | Complete Practice Book Easy Explanations
Q4
69-year-old man with HFrEF, weight gain 6 kg, congested. Got IV furosemide 40 mg ×2, poor urine output. BP 108/68, warm.
Next diuretic step?
A. Only higher continuous furosemide infusion
B. Add thiazide-type diuretic (metolazone/chlorothiazide) – sequential nephron blockade
C. Immediate ultrafiltration
D. Start dobutamine
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: When loop diuretic response is poor, adding a thiazide-type agent (sequential blockade) improves decongestion.
Supported by ADVOR and CLOROTIC trials.
Why others are wrong:
• A – Continuous infusion not superior (DOSE trial).
• C – Ultrafiltration only after failing medical therapy.
• D – Inotropes only if cold/hypoperfused.
Guideline / Trial: ADVOR; CLOROTIC; DOSE; ESC Acute HF
Q5
47-year-old woman with peripartum cardiomyopathy, EF 34% on 4 pillars, NYHA I, wants future pregnancy. Current advice on
drugs?
A. Continue all 4 drugs in pregnancy
B. Stop ARNI, MRA and SGLT2i before conception; beta-blocker can usually continue
C. Only stop SGLT2i
D. Switch now to hydralazine-nitrate + digoxin
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: ARNI/ACEI/ARB, MRA and SGLT2i are not safe in pregnancy and must be stopped before conception. Beta-blockers
are usually continued with monitoring.
Why others are wrong:
• A – These drugs harm the fetus.
• C – ARNI and MRA also must stop.
• D – Not needed while on effective contraception.
Guideline / Trial: ESC Pregnancy Guidelines 2018; ESC HF 2021
Q6
Diabetic man with HFrEF EF 30% on ARNI + carvedilol + spironolactone. eGFR 42. Can you add SGLT2i?
A. No, eGFR must be >45
B. Yes, dapagliflozin or empagliflozin can be started; benefit persists at this GFR
C. Only canagliflozin allowed
D. Wait till eGFR >60
Select the SINGLE best answer.
Correct Answer: B
Easy explanation: Dapagliflozin and empagliflozin are beneficial in HFrEF down to eGFR ~20–25. Do not delay for perfect kidney
function.
Why others are wrong:
• A – Threshold is lower for HF indication.
• C – Dapa/Empa preferred for HF.
• D – Unnecessary delay.
Guideline / Trial: DAPA-HF; EMPEROR-Reduced; ESC 2021/2023
Page 4 • +4 Correct • –1 Incorrect
