100+ Free Facharzt FMH Kardiologie Practice Questions

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Key Facts: Facharzt FMH Kardiologie Exam

SGK / SIWF

Exam Body

Swiss Society of Cardiology

EECC: 120 MCQs / 3 h

Written Exam

ESC / SGK Regulations

CHF 850

Exam Fee

SGK / SwissCardio Fee Schedule

EN written; DE/FR/IT oral

Exam Languages

SIWF Weiterbildungsprogramm 4.5.5

6 Years

Postgraduate Residency

SIWF Kardiologie Curriculum

100

Practice Bank Items

OpenExamPrep

The Facharzt FMH Kardiologie certifies physicians for specialist cardiology practice in Switzerland. Certification requires a 6-year postgraduate curriculum and passing three exam parts: the written European Exam in Core Cardiology (120 MCQs in English over 3 hours, CHF 300), a practical-clinical examination at the patient, and a practical-technical echocardiography examination (CHF 550 for both practical parts). This bank provides 100 high-yield English-language MCQ practice items covering ESC/SGK cardiology guidelines. Note: this is an English MCQ study adaptation, not an official exam simulation or clinical substitute — the real EECC uses five options per item, and neither practical part can be rehearsed through MCQs.

Sample Facharzt FMH Kardiologie Practice Questions

Try these sample questions to test your Facharzt FMH Kardiologie exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A 58-year-old man presents to a regional non-PCI hospital with severe retrosternal chest pain for 45 minutes. The 12-lead ECG demonstrates 3 mm ST-segment elevation in leads V1–V4 with reciprocal ST depression in leads II, III, and aVF. The anticipated transfer time to the nearest catheterization laboratory is 110 minutes, with an estimated first medical contact (FMC)-to-wire crossing time of 135 minutes. According to current ESC STEMI guidelines, what is the most appropriate reperfusion strategy?

A.Administer weight-adjusted intravenous tenecteplase immediately within 10 minutes, followed by urgent transfer to a PCI center for routine post-fibrinolysis coronary angiography within 2 to 24 hours.

B.Transfer the patient immediately for primary percutaneous coronary intervention without fibrinolysis, accepting the 135-minute delay since mechanical reperfusion is superior.

C.Initiate an unfractionated heparin infusion and dual antiplatelet therapy, deferring reperfusion decisions until high-sensitivity troponin T results confirm acute myocardial necrosis.

D.Administer intravenous eptifibatide monotherapy and arrange elective coronary angiography during the index hospitalization within 48 to 72 hours.

Explanation: ESC STEMI guidelines state that if primary PCI cannot be performed within 120 minutes of STEMI diagnosis, a pharmacoinvasive strategy is indicated. Weight-adjusted intravenous bolus fibrinolysis should be administered within 10 minutes of diagnosis in the absence of contraindications, followed by immediate transfer to a PCI-capable center for routine angiography within 2–24 hours (or immediate rescue PCI if reperfusion fails).

2A 62-year-old woman receives full-dose intravenous tenecteplase for an acute anterior STEMI at a community clinic. Ninety minutes after lytic administration, she reports persistent crushing chest pain (8/10), and repeat ECG reveals less than 20% resolution of the maximal ST-segment elevation in lead V3. What is the mandatory next step in management?

A.Administer a second full dose of intravenous tenecteplase to achieve complete enzymatic thrombus dissolution.

B.Switch to intravenous bivalirudin infusion and observe the patient in the coronary care unit for 6 hours.

C.Initiate high-dose intravenous nitroglycerin and wait 24 hours for delayed endogenous fibrinolysis.

D.Perform emergent coronary angiography and rescue percutaneous coronary intervention without delay.

Explanation: Failed fibrinolysis is defined as less than 50% ST-segment resolution in the lead with maximal ST elevation at 60–90 minutes post-administration, along with persistent chest pain. In failed fibrinolysis, emergent rescue PCI is strongly indicated (Class I recommendation) to restore coronary flow and salvage ischemic myocardium.

3A 69-year-old male with hypertension and chronic kidney disease presents with 2 hours of rest angina. ECG reveals 1.5 mm horizontal ST-segment depression in leads V4–V6 and T-wave inversion in lead I and aVL. High-sensitivity cardiac troponin T is elevated at 980 ng/L (upper reference limit 14 ng/L). He is hemodynamically stable without signs of heart failure, and his calculated GRACE risk score is 152. According to ESC NSTE-ACS guidelines, what is the recommended timing for invasive coronary angiography?

A.Immediate invasive strategy within 2 hours of hospital arrival.

B.Selective non-invasive functional ischemia testing prior to any angiography.

C.Elective coronary angiography performed within 72 hours after completing 3 days of medical stabilization.

D.Early invasive strategy with coronary angiography within 24 hours of hospital admission.

Explanation: Patients with confirmed NSTE-ACS exhibiting high-risk criteria—such as an established diagnosis of NSTEMI based on elevated cardiac troponin, dynamic ST/T changes, or a GRACE risk score > 140—should undergo an early invasive strategy within 24 hours of admission. An immediate invasive strategy (<2 hours) is reserved for very high-risk criteria (hemodynamic instability, cardiogenic shock, recurrent refractory chest pain, acute heart failure, or life-threatening arrhythmias).

4A 60-year-old man undergoes successful primary PCI with an everolimus-eluting stent to the proximal LAD for acute anterior STEMI. He has no prior history of stroke, transient ischemic attack, or bleeding diathesis, and his body weight is 82 kg. According to ESC ACS guidelines and head-to-head randomized trial evidence (ISAR-REACT 5), which oral antiplatelet regimen is preferred as default therapy for 12 months?

A.Aspirin 100 mg once daily plus clopidogrel 75 mg once daily.

B.Aspirin 100 mg once daily plus cilostazol 100 mg twice daily.

C.Ticagrelor 90 mg twice daily monotherapy without aspirin.

D.Aspirin 100 mg once daily plus prasugrel 10 mg once daily.

Explanation: ESC ACS guidelines recommend a potent P2Y12 inhibitor combined with low-dose aspirin for 12 months following PCI for acute coronary syndromes in patients without high bleeding risk. In the ISAR-REACT 5 trial, prasugrel demonstrated a significant reduction in the composite ischemic endpoint without increasing major bleeding compared with ticagrelor, making prasugrel 10 mg daily (with aspirin) a preferred option.

5A 78-year-old female with a history of major peptic ulcer bleeding 4 months ago and baseline anemia (hemoglobin 98 g/L) undergoes uncomplicated drug-eluting stent implantation for NSTEMI. She meets the Academic Research Consortium criteria for High Bleeding Risk (ARC-HBR). According to ESC ACS guidelines and the MASTER-DAPT trial, what is the most appropriate antithrombotic strategy?

A.Dual antiplatelet therapy for 1 month, followed by single antiplatelet monotherapy (e.g., clopidogrel or ticagrelor).

B.Dual antiplatelet therapy with aspirin and prasugrel for a mandatory minimum duration of 12 months.

C.Triple antithrombotic therapy with aspirin, clopidogrel, and rivaroxaban for 6 months.

D.Lifelong aspirin monotherapy starting on the day of PCI with complete avoidance of all P2Y12 inhibitors.

Explanation: In patients at high bleeding risk (ARC-HBR) presenting with ACS and undergoing PCI, shortening DAPT to 1 month followed by P2Y12 inhibitor (or aspirin) monotherapy significantly reduces major bleeding without increasing ischemic or stent thrombosis events, as established by MASTER-DAPT and endorsed by ESC guidelines.

6A 71-year-old male with permanent atrial fibrillation (CHA2DS2-VASc score = 4) and hypertension undergoes successful PCI with a second-generation drug-eluting stent for an acute non-ST-elevation myocardial infarction. What is the recommended default antithrombotic regimen upon discharge from the hospital?

A.Triple antithrombotic therapy with full-dose DOAC, aspirin, and ticagrelor continued for 6 months.

B.Warfarin with INR target 2.5–3.5 plus aspirin 100 mg daily, omitting P2Y12 inhibitors entirely.

C.Aspirin 100 mg daily plus prasugrel 10 mg daily for 12 months with complete discontinuation of oral anticoagulation.

D.Dual antithrombotic therapy comprising a DOAC at the stroke-prevention dose plus clopidogrel 75 mg daily, discontinuing aspirin after peri-procedural/in-hospital use.

Explanation: In patients with atrial fibrillation undergoing PCI for ACS, ESC guidelines recommend dual antithrombotic therapy (DAT) comprising a standard-dose DOAC plus clopidogrel 75 mg once daily as default therapy up to 12 months. Aspirin is dropped upon hospital discharge (or within <=1 week) to minimize bleeding risks without compromising stent thrombosis protection (AUGUSTUS and ENTRUST-AF PCI trials).

7A 64-year-old man with poorly controlled type 2 diabetes mellitus presents with Canadian Cardiovascular Society (CCS) Class III angina. Coronary angiography reveals 85% distal left main stenosis, 90% proximal LAD disease, 80% proximal circumflex stenosis, and a totally occluded mid-RCA. The calculated SYNTAX score is 35. Echocardiography shows an LVEF of 42%. After Heart Team evaluation, what is the preferred revascularization modality?

A.Percutaneous coronary intervention with multiple overlapping drug-eluting stents to all three coronary systems.

B.Balloon angioplasty alone to avoid foreign metal implants in diabetic coronary vasculature.

C.Optimal medical therapy alone without mechanical or surgical revascularization.

D.Coronary artery bypass grafting (CABG) with left internal mammary artery (LIMA) to the LAD and additional venous/arterial grafts.

Explanation: In diabetic patients with complex multi-vessel coronary artery disease involving the left main trunk and a high SYNTAX score (>= 33), CABG provides superior complete revascularization, lower long-term mortality, and significantly reduced repeat revascularization rates compared to PCI (Class I recommendation).

8During elective coronary angiography in a 59-year-old woman with chronic coronary syndrome, an intermediate 50% diameter stenosis is identified in the mid-LAD. Invasive physiological lesion assessment is performed using Fractional Flow Reserve (FFR) during intravenous adenosine-induced maximal hyperemia and instantaneous wave-free ratio (iFR) at rest. Which set of physiological cut-offs definitively indicates hemodynamic significance requiring revascularization?

A.FFR > 0.85 or iFR > 0.93.

B.FFR <= 0.70 only; iFR is not clinically validated for guiding revascularization.

C.FFR between 0.81 and 0.85 with an iFR > 0.90.

D.FFR <= 0.80 or iFR <= 0.89.

Explanation: Based on large randomized trials (FAME, DEFINE-FLAIR, iFR-SWEDEHEART), an FFR <= 0.80 under maximal hyperemia or a resting iFR <= 0.89 indicates lesion-specific myocardial ischemia. Lesions meeting these thresholds benefit from revascularization in terms of symptom relief and reduction in major adverse cardiovascular events.

9A 52-year-old woman presents with recurrent exertional chest tightness and a positive exercise stress ECG showing 2 mm ST depression. Diagnostic coronary angiography reveals smooth, angiographically normal epicardial coronary arteries. Comprehensive invasive physiological assessment using intracoronary thermodilution and acetylcholine provocation demonstrates a coronary flow reserve (CFR) of 1.7 (<2.0), an index of microcirculatory resistance (IMR) of 32 (>=25), and absence of epicardial spasm. What is the definitive diagnosis?

A.Microvascular angina (coronary microvascular dysfunction).

B.Epicardial vasospastic (Prinzmetal) angina.

C.Non-cardiac chest pain of musculoskeletal origin.

D.Subclinical pulmonary arterial hypertension.

Explanation: Coronary microvascular dysfunction (CMD) causing microvascular angina is diagnosed when epicardial coronaries are non-obstructive and invasive testing confirms impaired microvascular vasodilator capacity (CFR < 2.0) or elevated microcirculatory resistance (IMR >= 25) in response to adenosine, without epicardial vasospasm on acetylcholine testing.

10A 60-year-old male presents with acute retrosternal chest pain and high-sensitivity troponin I elevation to 2,400 ng/L. Urgent coronary angiography reveals normal coronary arteries without obstructive plaque, thrombus, or dissection (MINOCA). What is the key diagnostic imaging modality recommended by ESC guidelines to establish the underlying myocardial etiology?

A.Non-contrast computed tomography of the chest.

B.Repeat coronary angiography at 48 hours with high-dose intracoronary nitroglycerin.

C.Transesophageal echocardiography for patent foramen ovale detection.

D.Cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement and T1/T2 mapping.

Explanation: Cardiac magnetic resonance (CMR) imaging is the cornerstone diagnostic investigation in patients with MINOCA (Class I recommendation in ESC guidelines). CMR allows differentiation between true ischemic myocardial infarction (subendocardial/transmural LGE), acute myocarditis (subepicardial/midwall LGE with edema on T2 mapping), Takotsubo syndrome (apical/mid-ventricular edema without LGE), and non-ischemic cardiomyopathies.

About the Facharzt FMH Kardiologie Exam

The Facharzt FMH für Kardiologie is the federally recognized specialist title in cardiology in Switzerland, conferring full authority for independent clinical and invasive cardiology practice. Regulated by SIWF and governed by the SGK (Schweizerische Gesellschaft für Kardiologie / SwissCardio), board certification requires completing a 6-year postgraduate curriculum, documenting certified procedural numbers in the SIWF e-Logbook, passing the written European Exam in Core Cardiology (EECC, 120 MCQs conducted in English in collaboration with the ESC), and passing both Swiss practical parts — a clinical examination at the patient and a technical examination in echocardiography. Note on study adaptation: This question bank is an independent English-language MCQ practice resource created by OpenExamPrep—not an official release of the SGK, ESC, or SIWF—designed to reinforce core theoretical knowledge across coronary artery disease, heart failure, electrophysiology, valvular heart disease, and prevention.

Assessment

Three-part examination (Weiterbildungsprogramm 4.4): (1) written European Exam in Core Cardiology — 120 MCQs in English over 3 hours, delivered online with remote proctoring; (2) practical-clinical examination at the patient using history, status and the patient record, approx. 30–45 minutes; (3) practical-technical examination in which the candidate performs and interprets an echocardiographic study, approx. 40 minutes. The written part must be passed before admission to the two practical parts; the practical parts are held in German, French or Italian, and in English with the candidate's agreement.

Time Limit

EECC written paper 180 minutes with no break; practical-clinical examination approx. 30–45 minutes; practical-technical echocardiography examination approx. 40 minutes

Passing Score

Each of the three parts is graded «bestanden» / «nicht bestanden» and all three must be passed; only a failed part must be repeated. The EECC cut score is determined after each sitting by the ESC standard-setting group and is not published in advance.

Exam Fee

Written EECC fee CHF 300, Swiss practical/oral examination fee CHF 550 (total examination fee CHF 850), plus SIWF title issuance fee (Schweizerisches Institut für ärztliche Weiter- und Fortbildung (SIWF / FMH) & Schweizerische Gesellschaft für Kardiologie (SGK / SSC))

Facharzt FMH Kardiologie Exam Content Outline

20%

Ischemic Heart Disease & Acute Coronary Syndromes

STEMI primary PCI pathways, reperfusion timelines, pharmacoinvasive strategy, cardiogenic shock in ACS (culprit-only vs multivessel PCI, mechanical circulatory support), NSTEMI risk stratification (GRACE score, invasive timing), antiplatelet therapy (DAPT duration, de-escalation, triple therapy in AF/PCI), parenteral anticoagulation, chronic coronary syndromes non-invasive ischemia testing vs CCTA, invasive physiology (FFR/iFR), revascularization decisions (SYNTAX score, CABG vs PCI), and MINOCA/INOCA evaluation.

20%

Heart Failure, Cardiomyopathies & Myocarditis

HFrEF four-pillar guideline-directed medical therapy (ARNI, beta-blockers, MRAs, SGLT2 inhibitors), HFpEF management, device therapies (ICD primary/secondary prevention, CRT-D/CRT-P, conduction system pacing), hypertrophic cardiomyopathy (ESC HCM Risk-SCD, mavacamten, surgical myectomy vs alcohol ablation), cardiac amyloidosis (ATTR 99mTc-PYP scintigraphy vs AL light chains, tafamidis), myocarditis, and acute decompensated heart failure.

20%

Arrhythmias, Electrophysiology & Device Therapy

Atrial fibrillation (CHA2DS2-VASc, HAS-BLED, DOAC dosing, early rhythm vs rate control, catheter ablation PVI), SVTs (AVNRT, AVRT/WPW, atrial flutter), ventricular arrhythmias (VT ablation, electrical storm), inherited arrhythmia syndromes (Long QT syndrome, Brugada syndrome, CPVT, ARVC), and bradyarrhythmias/permanent pacing indications.

15%

Valvular Heart Disease & Endocarditis

Aortic stenosis (severity criteria, classical and paradoxical low-flow low-gradient AS, TAVI vs SAVR selection), aortic regurgitation, mitral regurgitation (primary degenerative repair vs secondary functional TEER/MitraClip), tricuspid regurgitation, prosthetic valve management, and infective endocarditis (modified Duke criteria, antimicrobial therapy, urgent surgical indications).

15%

Cardiovascular Prevention, Hypertension & Vascular Disease

ESC cardiovascular risk assessment (SCORE2/SCORE2-OP), intensive dyslipidemia therapy (statins, ezetimibe, PCSK9 inhibitors, bempedoic acid, inclisiran), resistant hypertension (spironolactone, renal denervation), acute aortic syndromes (Stanford Type A emergent surgery vs Type B medical/TEVAR), aortic aneurysms, and peripheral artery disease.

10%

Congenital, Pericardial & Pulmonary Vascular Diseases

Adult congenital heart disease (ASD/VSD shunt quantification Qp:Qs, coarctation of aorta, repaired Tetralogy of Fallot), acute pericarditis (diagnostic criteria, NSAIDs + colchicine, IL-1 blockers), cardiac tamponade (pulsus paradoxus, emergency pericardiocentesis), constrictive pericarditis vs restrictive cardiomyopathy, pulmonary arterial hypertension, and primary cardiac tumors.

How to Pass the Facharzt FMH Kardiologie Exam

What You Need to Know

Passing score: Each of the three parts is graded «bestanden» / «nicht bestanden» and all three must be passed; only a failed part must be repeated. The EECC cut score is determined after each sitting by the ESC standard-setting group and is not published in advance.
Assessment: Three-part examination (Weiterbildungsprogramm 4.4): (1) written European Exam in Core Cardiology — 120 MCQs in English over 3 hours, delivered online with remote proctoring; (2) practical-clinical examination at the patient using history, status and the patient record, approx. 30–45 minutes; (3) practical-technical examination in which the candidate performs and interprets an echocardiographic study, approx. 40 minutes. The written part must be passed before admission to the two practical parts; the practical parts are held in German, French or Italian, and in English with the candidate's agreement.
Time limit: EECC written paper 180 minutes with no break; practical-clinical examination approx. 30–45 minutes; practical-technical echocardiography examination approx. 40 minutes
Exam fee: Written EECC fee CHF 300, Swiss practical/oral examination fee CHF 550 (total examination fee CHF 850), plus SIWF title issuance fee

Keys to Passing

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Facharzt FMH Kardiologie Study Tips from Top Performers

1Master ESC Guideline Algorithms and Class I/III Recommendations: The EECC and SGK examinations heavily emphasize Class I (recommended) and Class III (harmful/not recommended) recommendations across ACS, Heart Failure, Atrial Fibrillation, Valvular Heart Disease, and Prevention.

2Consolidate Heart Failure GDMT Sequencing: Understand the evidence and practical initiation order for the 4 pillars of HFrEF therapy (ARNI, beta-blocker, MRA, SGLT2i), potassium binder use for hyperkalemia, and specific therapies for HFpEF, cardiac amyloidosis (tafamidis), and HCM (mavacamten).

3Internalize Coronary Revascularization & Antiplatelet Strategies: Memorize the exact indications and durations for DAPT, DAPT de-escalation, and triple vs dual antithrombotic therapy in patients with atrial fibrillation undergoing PCI.

4Review Multimodality Cardiac Imaging Patterns: Know how to interpret echocardiographic Doppler parameters (aortic valve continuity equation, low-flow low-gradient AS, E/e' ratio), cardiac MRI tissue characterization (ischemic vs non-ischemic LGE patterns), and coronary CTA CAD-RADS classifications.

5Practice Electrocardiogram & Arrhythmia Problem Solving: Sharpen skills in distinguishing wide-complex tachycardias (Brugada and Vereckei criteria for VT vs SVT with aberrancy) and recognizing channelopathy ECG patterns (Brugada, Long QT, ARVC).

Frequently Asked Questions

What is the Facharzt FMH für Kardiologie examination?

The Facharztprüfung FMH für Kardiologie is the official postgraduate certification examination required to obtain the Swiss Federal Specialist Title in Cardiology. Governed by SIWF/FMH and the Swiss Society of Cardiology (SGK/SSC), the written component is the European Exam in Core Cardiology (EECC) organized with the European Society of Cardiology (ESC), followed by two Swiss practical parts — a clinical examination at the patient and a technical examination in echocardiography. Note: This question bank is an English-language MCQ study adaptation—not an official translation, not a simulation of the practical/oral format, and not a substitute for supervised clinical training.

What is the examination format, language, and fee structure?

The specialist qualification comprises three parts. (1) The written European Exam in Core Cardiology (EECC): 120 single-best-answer multiple-choice questions with five options and no negative marking, administered in English over 3 hours with no break, delivered online under remote proctoring on a single day each June (fee CHF 300). (2) A practical-clinical examination at the patient, based on history, status and the patient record, lasting roughly 30 to 45 minutes. (3) A practical-technical examination in which the candidate performs and interprets an echocardiographic study, lasting roughly 40 minutes. The two practical parts cost CHF 550 together and are held in German, French or Italian — or in English if the candidate agrees. Passing the written part is a precondition for sitting the practical parts. Total examination fees are CHF 850 plus the statutory SIWF title fee.

How is the passing score determined for the Swiss Cardiology Specialist Title?

There is no fixed published percentage. The EECC cut score is set after each sitting by the exam's standard-setting group on the basis of how the delivered paper actually performed, so it is not announced in advance. Under the SIWF Weiterbildungsprogramm each of the three parts is simply graded «bestanden» or «nicht bestanden», the overall result is pass or fail, and the examination may be repeated as often as necessary — only the failed part has to be retaken.

What core clinical cardiology domains are tested on the examination?

The exam blueprint covers 6 core syllabus areas: Ischemic Heart Disease & Acute Coronary Syndromes (20%), Heart Failure, Cardiomyopathies & Myocarditis (20%), Arrhythmias, Electrophysiology & Device Therapy (20%), Valvular Heart Disease & Endocarditis (15%), Cardiovascular Prevention, Hypertension & Vascular Disease (15%), and Congenital, Pericardial & Pulmonary Vascular Diseases (10%).

How do European Society of Cardiology (ESC) guidelines integrate with Swiss clinical practice?

The Swiss Society of Cardiology (SGK / SSC) officially endorses and adopts ESC Clinical Practice Guidelines as the national standard of clinical care and the official blueprint for the Facharzt certification, alongside SGK working group position papers and Swissmedic / BAG healthcare reimbursement regulations.

100+ Free Facharzt FMH Kardiologie Practice Questions

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