CARDIOLOGY BOARDS ABIM
REVIEW SHEET 2026 FULL
QUESTIONS AND ACCURATE
ANSWERS
◉ When to stop a stress test. Answer: St segment depression > 2 mm,
ventricular tachycardia, drop in SBP > 15, chest pain, dyspnea,
lightheadedness
◉ Stress test of choice with a LBBB or ventricular pacing?. Answer:
Myocardial perfusion imaging with adenosine,NOT exercising!
◉ Know the algorithm for stress testing. Answer: See page 5-3,figure 5-
1
◉ When to not use doutamine for stress. Answer: History of VT, severe
HTN, Low BP, poor echo images
◉ When to not use adenosine for stress. Answer: Bronchospasm, severe
valvular dysfunction, severe carotid stenosis, 2nd degree heart block,
theophylline dependent
◉ Normals for PA catheter pressures. Answer: RA <7, RV 30/7, PCWP
3-11
,◉ PA cath findings in tamponade or restrictive pericarditis. Answer:
Diastolic pressures elevated and equalized in all chambers, low BP
◉ PA cath findings with RV AMI. Answer: Elevated RA and PA
pressures, decreased or nl PCWP, hypotension, and inferior MI. R side is
decompensated, cannot fill L side of the heart
◉ PA cath findings in cardiogenic shock. Answer: Elevated PCWP, RA
pressure, and decreased SBP/cardiac output
◉ PA cath findings in mitral stenosis with RV failure. Answer: Elevated
RA, PA (very elevated), PCWP, nl SBP
◉ PA cath findings in pulmonary HTN. Answer: Elevated PA, RA
pressures, nl PCWP, SBP
◉ Pulsus paradoxus. Answer: decrease in systolic BP of more than
10mmHg with normal inspiration; palpated as weakened pulse with
inspiration along with more heart contractions to pulse beats
◉ What conditions give you pulsus paradoxus?. Answer: Constrictive or
restrictive pericarditis, asthma, tension pneumothorax
◉ What gives you pulsus bisferiens (two systolic peaks per cycle).
Answer: Aortic regurgitation, HOCM
,◉ What causes pulsus alternans. Answer: Severe LV dysfunction
◉ What causes pulsus tardus. Answer: Aortic stenosis
◉ How do positional maneuvers affect blood flow and murmurs.
Answer: -standing/valsalva - decreased cardiac filling, decreases most
murmurs except MVP and HOCM
-squatting/ lying down - increase cardiac volume, increased murmurs
except MVP, HOCM
-sustained handgrip - increases systemic resistance, decreases murmur in
HOCM, AS
◉ What causes a physiologic split S2. Answer: Increased blood volume
in the RV prolongs systole and delays pulmonary valve closure
◉ What causes a fixed split S2. Answer: Pulmonary stenosis, PE, LV
pacer, RBBB, MR (early AV closure), ASD, RV failue
◉ What causes a paradoxic split S2. Answer: LBBB, RV pacing,
HOCM
◉ What causes an S3?. Answer: Rapid LV filling - acute ventricular
decompensation, severe AR or MR
◉ KNOW - S3 with LV dysfunction is a poor prognostic factor.
Answer: ...
, ◉ What causes a S4?. Answer: Decreased ventricular compliance during
atrial contraction - ischemic heart dz, AS, MR, HOCM, hypertrophic or
diabetic cardiomyopathy, HTN heart dz, concentric LVH
◉ Can you have a S4 with atrial fibrillation?. Answer: No - no atrial
contraction
◉ What are the parts of the venous waveform?. Answer: A wave - atrial
contraction
X descent - atria relax, RV fills rapidly
Bottom of x descent is TC valve closure
V wave - ventricle contacting against closed TC valve
Y descent - TC valve opens, passive emptying into ventricle
◉ What gives elevated a and v waves. Answer: Pulmonary HTN, RV
infarction
◉ Large r side v waves. Answer: Septal rupture
◉ Large v waves. Answer: TR (right), MR (left)
◉ Rapid x and y descent. Answer: Constrictive pericarditis, restrictive
cardiomyopathy, tamponade (x descent only, loss of y descent)
REVIEW SHEET 2026 FULL
QUESTIONS AND ACCURATE
ANSWERS
◉ When to stop a stress test. Answer: St segment depression > 2 mm,
ventricular tachycardia, drop in SBP > 15, chest pain, dyspnea,
lightheadedness
◉ Stress test of choice with a LBBB or ventricular pacing?. Answer:
Myocardial perfusion imaging with adenosine,NOT exercising!
◉ Know the algorithm for stress testing. Answer: See page 5-3,figure 5-
1
◉ When to not use doutamine for stress. Answer: History of VT, severe
HTN, Low BP, poor echo images
◉ When to not use adenosine for stress. Answer: Bronchospasm, severe
valvular dysfunction, severe carotid stenosis, 2nd degree heart block,
theophylline dependent
◉ Normals for PA catheter pressures. Answer: RA <7, RV 30/7, PCWP
3-11
,◉ PA cath findings in tamponade or restrictive pericarditis. Answer:
Diastolic pressures elevated and equalized in all chambers, low BP
◉ PA cath findings with RV AMI. Answer: Elevated RA and PA
pressures, decreased or nl PCWP, hypotension, and inferior MI. R side is
decompensated, cannot fill L side of the heart
◉ PA cath findings in cardiogenic shock. Answer: Elevated PCWP, RA
pressure, and decreased SBP/cardiac output
◉ PA cath findings in mitral stenosis with RV failure. Answer: Elevated
RA, PA (very elevated), PCWP, nl SBP
◉ PA cath findings in pulmonary HTN. Answer: Elevated PA, RA
pressures, nl PCWP, SBP
◉ Pulsus paradoxus. Answer: decrease in systolic BP of more than
10mmHg with normal inspiration; palpated as weakened pulse with
inspiration along with more heart contractions to pulse beats
◉ What conditions give you pulsus paradoxus?. Answer: Constrictive or
restrictive pericarditis, asthma, tension pneumothorax
◉ What gives you pulsus bisferiens (two systolic peaks per cycle).
Answer: Aortic regurgitation, HOCM
,◉ What causes pulsus alternans. Answer: Severe LV dysfunction
◉ What causes pulsus tardus. Answer: Aortic stenosis
◉ How do positional maneuvers affect blood flow and murmurs.
Answer: -standing/valsalva - decreased cardiac filling, decreases most
murmurs except MVP and HOCM
-squatting/ lying down - increase cardiac volume, increased murmurs
except MVP, HOCM
-sustained handgrip - increases systemic resistance, decreases murmur in
HOCM, AS
◉ What causes a physiologic split S2. Answer: Increased blood volume
in the RV prolongs systole and delays pulmonary valve closure
◉ What causes a fixed split S2. Answer: Pulmonary stenosis, PE, LV
pacer, RBBB, MR (early AV closure), ASD, RV failue
◉ What causes a paradoxic split S2. Answer: LBBB, RV pacing,
HOCM
◉ What causes an S3?. Answer: Rapid LV filling - acute ventricular
decompensation, severe AR or MR
◉ KNOW - S3 with LV dysfunction is a poor prognostic factor.
Answer: ...
, ◉ What causes a S4?. Answer: Decreased ventricular compliance during
atrial contraction - ischemic heart dz, AS, MR, HOCM, hypertrophic or
diabetic cardiomyopathy, HTN heart dz, concentric LVH
◉ Can you have a S4 with atrial fibrillation?. Answer: No - no atrial
contraction
◉ What are the parts of the venous waveform?. Answer: A wave - atrial
contraction
X descent - atria relax, RV fills rapidly
Bottom of x descent is TC valve closure
V wave - ventricle contacting against closed TC valve
Y descent - TC valve opens, passive emptying into ventricle
◉ What gives elevated a and v waves. Answer: Pulmonary HTN, RV
infarction
◉ Large r side v waves. Answer: Septal rupture
◉ Large v waves. Answer: TR (right), MR (left)
◉ Rapid x and y descent. Answer: Constrictive pericarditis, restrictive
cardiomyopathy, tamponade (x descent only, loss of y descent)
