ABIM INTERVENTIONAL CARDIOLOGY CERTIFICATION EXAM
ACTUAL 2026/2027 QUESTION BANK , PRACTICE QUESTIONS AND
STUDY GUIDE ACCURATE EXAM COMPLETE APPROVED
QUESTIONS WITH WELL ELABORATED SOLUTIONS AND DETAILED
RATIONALES (100% CORRECT VERIFIED ANSWERS) CURRENTLY
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |INSTANT
DOWNLOAD PDF |JUST RELEASED
1. A 62-year-old male with non-ST-elevation myocardial infarction
(NSTEMI) and high-risk features (elevated troponin, ST depression)
undergoes coronary angiography. The left main coronary artery has
a 70% distal stenosis involving the ostium of the left anterior
descending (LAD) and left circumflex (LCx). What is the most
appropriate revascularization strategy?
A) Percutaneous coronary intervention (PCI) with drug-eluting
stents
B) Medical therapy alone
C) Coronary artery bypass grafting (CABG) with PCI of the left
main
D) Coronary artery bypass grafting (CABG)
Correct Answer: D
Rationale: Left main coronary artery disease with bifurcation
involvement (distal LM) has lower mortality with CABG compared
,to PCI based on the SYNTAX trial. PCI is an alternative only for
patients with low SYNTAX scores or prohibitive surgical risk.
CABG remains the standard of care for complex left main disease
with bifurcation involvement.
2. A 58-year-old male presents with an acute inferior STEMI.
Emergent angiography shows a 100% occluded right coronary artery
(RCA) with heavy thrombus burden. After wiring the vessel,
thrombus aspiration is performed, but there is no reflow. What is the
most appropriate next step?
A) Intra-aortic balloon pump (IABP)
B) Intracoronary vasodilators (nitroprusside, adenosine, verapamil)
C) Stent implantation
D) Emergent CABG
Correct Answer: B
Rationale: No-reflow phenomenon after PCI is managed with
intracoronary vasodilators such as adenosine, nitroprusside, or
verapamil to improve microvascular flow. Stenting should be
deferred until flow improves to avoid propagating the no-reflow
state.
,3. Which coronary artery most commonly supplies the
atrioventricular (AV) node in a right-dominant circulation?
A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
D) Posterior descending artery (PDA)
Correct Answer: C
Rationale: In approximately 85-90% of individuals with right-
dominant circulation, the RCA gives rise to the AV nodal artery,
which supplies the AV node.
4. Fractional flow reserve (FFR) is best defined as:
A) Ratio of resting coronary pressures
B) Ratio of hyperemic distal coronary pressure to aortic pressure
C) Absolute coronary blood flow
D) Index of microvascular resistance
Correct Answer: B
, Rationale: FFR is defined as the ratio of distal coronary pressure
(Pd) to aortic pressure (Pa) during maximal hyperemia, reflecting
lesion-specific ischemia.
5. An FFR value ≤0.80 generally indicates:
A) Normal coronary physiology
B) Non-obstructive CAD
C) Ischemia-producing lesion
D) Vasospastic disease
Correct Answer: C
Rationale: An FFR ≤0.80 correlates with inducible ischemia and
identifies lesions that benefit from revascularization based on the
FAME and FAME 2 trials.
6. Instantaneous wave-free ratio (iFR) is measured:
A) During maximal hyperemia
B) During systole
ACTUAL 2026/2027 QUESTION BANK , PRACTICE QUESTIONS AND
STUDY GUIDE ACCURATE EXAM COMPLETE APPROVED
QUESTIONS WITH WELL ELABORATED SOLUTIONS AND DETAILED
RATIONALES (100% CORRECT VERIFIED ANSWERS) CURRENTLY
UPDATED VERSION 2026 EDITION |GUARANTEED PASS A+ |INSTANT
DOWNLOAD PDF |JUST RELEASED
1. A 62-year-old male with non-ST-elevation myocardial infarction
(NSTEMI) and high-risk features (elevated troponin, ST depression)
undergoes coronary angiography. The left main coronary artery has
a 70% distal stenosis involving the ostium of the left anterior
descending (LAD) and left circumflex (LCx). What is the most
appropriate revascularization strategy?
A) Percutaneous coronary intervention (PCI) with drug-eluting
stents
B) Medical therapy alone
C) Coronary artery bypass grafting (CABG) with PCI of the left
main
D) Coronary artery bypass grafting (CABG)
Correct Answer: D
Rationale: Left main coronary artery disease with bifurcation
involvement (distal LM) has lower mortality with CABG compared
,to PCI based on the SYNTAX trial. PCI is an alternative only for
patients with low SYNTAX scores or prohibitive surgical risk.
CABG remains the standard of care for complex left main disease
with bifurcation involvement.
2. A 58-year-old male presents with an acute inferior STEMI.
Emergent angiography shows a 100% occluded right coronary artery
(RCA) with heavy thrombus burden. After wiring the vessel,
thrombus aspiration is performed, but there is no reflow. What is the
most appropriate next step?
A) Intra-aortic balloon pump (IABP)
B) Intracoronary vasodilators (nitroprusside, adenosine, verapamil)
C) Stent implantation
D) Emergent CABG
Correct Answer: B
Rationale: No-reflow phenomenon after PCI is managed with
intracoronary vasodilators such as adenosine, nitroprusside, or
verapamil to improve microvascular flow. Stenting should be
deferred until flow improves to avoid propagating the no-reflow
state.
,3. Which coronary artery most commonly supplies the
atrioventricular (AV) node in a right-dominant circulation?
A) Left anterior descending (LAD)
B) Left circumflex (LCx)
C) Right coronary artery (RCA)
D) Posterior descending artery (PDA)
Correct Answer: C
Rationale: In approximately 85-90% of individuals with right-
dominant circulation, the RCA gives rise to the AV nodal artery,
which supplies the AV node.
4. Fractional flow reserve (FFR) is best defined as:
A) Ratio of resting coronary pressures
B) Ratio of hyperemic distal coronary pressure to aortic pressure
C) Absolute coronary blood flow
D) Index of microvascular resistance
Correct Answer: B
, Rationale: FFR is defined as the ratio of distal coronary pressure
(Pd) to aortic pressure (Pa) during maximal hyperemia, reflecting
lesion-specific ischemia.
5. An FFR value ≤0.80 generally indicates:
A) Normal coronary physiology
B) Non-obstructive CAD
C) Ischemia-producing lesion
D) Vasospastic disease
Correct Answer: C
Rationale: An FFR ≤0.80 correlates with inducible ischemia and
identifies lesions that benefit from revascularization based on the
FAME and FAME 2 trials.
6. Instantaneous wave-free ratio (iFR) is measured:
A) During maximal hyperemia
B) During systole
