ABIM INTERVENTIONAL CARDIOLOGY CERTIFICATION EXAM
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Case Selection and Management
Procedural Techniques
Complications of Coronary Intervention
Catheter-Based Management of Noncoronary Disease
Basic Science
Anatomy, Anatomic Variants, and Anatomic Pathology
Pharmacology
Cardiac Imaging and Assessment
Miscellaneous
Introduction
The purpose of this assessment is to evaluate the knowledge and
clinical judgment required of an interventional cardiologist across
the breadth of the specialty. It assesses skills in diagnosis,
procedural planning and execution, management of acute
coronary syndromes, recognition and treatment of complications,
and integration of evidence-based guidelines into real-world
decision-making. The structure consists of multiple-choice and
scenario-based questions designed to mirror the complexity of
clinical practice. Emphasis is placed on the application of
foundational science, regulatory and ethical standards, and critical
thinking to patient care situations encountered in the
catheterization laboratory and beyond.
,SECTION ONE: QUESTIONS 1–100
1. A 67-year-old male with chronic stable angina and a single
proximal LAD stenosis undergoes FFR assessment. The baseline
aortic pressure is 95 mm Hg. During maximal hyperemia, the
mean distal coronary pressure is 78 mm Hg. What is the FFR
value and what is the appropriate management?
A. 0.82; defer revascularization
B. 0.78; perform PCI
C. 0.82; perform PCI
D. 0.78; defer revascularization
🟢 Correct answer
B. 0.78; perform PCI
🔴 RATIONALE: FFR is calculated as distal coronary pressure
divided by aortic pressure during maximal hyperemia (78/95 ≈
0.82). However, the correct calculation yields 0.82, which is above
the ischemic threshold of ≤0.80. Wait, let me recalculate. 78/95 =
0.821. The threshold for ischemia is ≤0.80. Therefore, FFR is 0.82,
which is not ischemic. The correct answer should be A. Let me
correct this.
🟢 Correct answer
A. 0.82; defer revascularization
🔴 RATIONALE: FFR is calculated as Pd/Pa during hyperemia. 78 ÷
95 = 0.82. An FFR value greater than 0.80 indicates that the
stenosis is not hemodynamically significant, and revascularization
can be safely deferred with guideline-directed medical therapy.
2. A 72-year-old female presents with STEMI and is taken for
primary PCI. During balloon inflation in the proximal RCA, she
,develops severe hypotension and bradycardia. Which vagal
maneuver is most appropriate to consider?
A. Intravenous adenosine
B. Intravenous atropine
C. Intravenous metoprolol
D. Intravenous diltiazem
🟢 Correct answer
B. Intravenous atropine
🔴 RATIONALE: Right coronary artery interventions commonly
trigger Bezold-Jarisch reflex, causing bradycardia and
hypotension. Atropine is the first-line treatment for symptomatic
bradycardia in this setting.
3. A 58-year-old male with NSTEMI is scheduled for cardiac
catheterization. His creatinine is 2.8 mg/dL. Which strategy best
reduces the risk of contrast-associated acute kidney injury?
A. Use of high-osmolar contrast agents
B. Adequate hydration with isotonic saline and minimizing
contrast volume
C. Routine administration of nephrotoxic antibiotics
D. Deferral of all catheterization regardless of clinical urgency
🟢 Correct answer
B. Adequate hydration with isotonic saline and minimizing
contrast volume
🔴 RATIONALE: Prevention of contrast-induced nephropathy
focuses on volume expansion, using lowest possible contrast
volume, and avoiding additional nephrotoxins.
4. During PCI of a calcified lesion, the balloon fails to fully
expand. Which adjunctive device is most appropriate for lesion
, modification?
A. Cutting balloon
B. Rotational atherectomy
C. Thrombectomy catheter
D. Embolic protection device
🟢 Correct answer
B. Rotational atherectomy
🔴 RATIONALE: Rotational atherectomy uses a diamond-coated
burr to ablate calcified plaque, facilitating subsequent balloon
expansion and stent delivery.
5. A patient undergoing PCI develops abrupt chest pain with ST
elevation immediately after stent deployment. Angiography
shows a filling defect within the stent. What is the most likely
diagnosis?
A. Coronary perforation
B. Acute stent thrombosis
C. Coronary spasm
D. Side branch occlusion
🟢 Correct answer
B. Acute stent thrombosis
🔴 RATIONALE: Acute stent thrombosis presents with abrupt
ischemic symptoms, ST changes, and angiographic filling defect
within the stent, often due to inadequate antiplatelet therapy,
stent malapposition, or dissection.
6. A 64-year-old male with severe aortic stenosis and prohibitive
surgical risk is evaluated for transcatheter aortic valve
replacement. Which access site is most commonly used for
TAVR?
QUESTIONS AND CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A | INSTANT DOWNLOAD PDF.
Core Domains
Case Selection and Management
Procedural Techniques
Complications of Coronary Intervention
Catheter-Based Management of Noncoronary Disease
Basic Science
Anatomy, Anatomic Variants, and Anatomic Pathology
Pharmacology
Cardiac Imaging and Assessment
Miscellaneous
Introduction
The purpose of this assessment is to evaluate the knowledge and
clinical judgment required of an interventional cardiologist across
the breadth of the specialty. It assesses skills in diagnosis,
procedural planning and execution, management of acute
coronary syndromes, recognition and treatment of complications,
and integration of evidence-based guidelines into real-world
decision-making. The structure consists of multiple-choice and
scenario-based questions designed to mirror the complexity of
clinical practice. Emphasis is placed on the application of
foundational science, regulatory and ethical standards, and critical
thinking to patient care situations encountered in the
catheterization laboratory and beyond.
,SECTION ONE: QUESTIONS 1–100
1. A 67-year-old male with chronic stable angina and a single
proximal LAD stenosis undergoes FFR assessment. The baseline
aortic pressure is 95 mm Hg. During maximal hyperemia, the
mean distal coronary pressure is 78 mm Hg. What is the FFR
value and what is the appropriate management?
A. 0.82; defer revascularization
B. 0.78; perform PCI
C. 0.82; perform PCI
D. 0.78; defer revascularization
🟢 Correct answer
B. 0.78; perform PCI
🔴 RATIONALE: FFR is calculated as distal coronary pressure
divided by aortic pressure during maximal hyperemia (78/95 ≈
0.82). However, the correct calculation yields 0.82, which is above
the ischemic threshold of ≤0.80. Wait, let me recalculate. 78/95 =
0.821. The threshold for ischemia is ≤0.80. Therefore, FFR is 0.82,
which is not ischemic. The correct answer should be A. Let me
correct this.
🟢 Correct answer
A. 0.82; defer revascularization
🔴 RATIONALE: FFR is calculated as Pd/Pa during hyperemia. 78 ÷
95 = 0.82. An FFR value greater than 0.80 indicates that the
stenosis is not hemodynamically significant, and revascularization
can be safely deferred with guideline-directed medical therapy.
2. A 72-year-old female presents with STEMI and is taken for
primary PCI. During balloon inflation in the proximal RCA, she
,develops severe hypotension and bradycardia. Which vagal
maneuver is most appropriate to consider?
A. Intravenous adenosine
B. Intravenous atropine
C. Intravenous metoprolol
D. Intravenous diltiazem
🟢 Correct answer
B. Intravenous atropine
🔴 RATIONALE: Right coronary artery interventions commonly
trigger Bezold-Jarisch reflex, causing bradycardia and
hypotension. Atropine is the first-line treatment for symptomatic
bradycardia in this setting.
3. A 58-year-old male with NSTEMI is scheduled for cardiac
catheterization. His creatinine is 2.8 mg/dL. Which strategy best
reduces the risk of contrast-associated acute kidney injury?
A. Use of high-osmolar contrast agents
B. Adequate hydration with isotonic saline and minimizing
contrast volume
C. Routine administration of nephrotoxic antibiotics
D. Deferral of all catheterization regardless of clinical urgency
🟢 Correct answer
B. Adequate hydration with isotonic saline and minimizing
contrast volume
🔴 RATIONALE: Prevention of contrast-induced nephropathy
focuses on volume expansion, using lowest possible contrast
volume, and avoiding additional nephrotoxins.
4. During PCI of a calcified lesion, the balloon fails to fully
expand. Which adjunctive device is most appropriate for lesion
, modification?
A. Cutting balloon
B. Rotational atherectomy
C. Thrombectomy catheter
D. Embolic protection device
🟢 Correct answer
B. Rotational atherectomy
🔴 RATIONALE: Rotational atherectomy uses a diamond-coated
burr to ablate calcified plaque, facilitating subsequent balloon
expansion and stent delivery.
5. A patient undergoing PCI develops abrupt chest pain with ST
elevation immediately after stent deployment. Angiography
shows a filling defect within the stent. What is the most likely
diagnosis?
A. Coronary perforation
B. Acute stent thrombosis
C. Coronary spasm
D. Side branch occlusion
🟢 Correct answer
B. Acute stent thrombosis
🔴 RATIONALE: Acute stent thrombosis presents with abrupt
ischemic symptoms, ST changes, and angiographic filling defect
within the stent, often due to inadequate antiplatelet therapy,
stent malapposition, or dissection.
6. A 64-year-old male with severe aortic stenosis and prohibitive
surgical risk is evaluated for transcatheter aortic valve
replacement. Which access site is most commonly used for
TAVR?
