100+ Free EECC Practice Questions

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2026 Statistics

Key Facts: EECC Exam

120 MCQs

Single-best-answer questions on the EECC, each a clinical stem with five options

British Cardiovascular Society - EECC

3 hours

Total exam time with no scheduled break

British Cardiovascular Society - EECC

Best of five

Each question has five options with one best answer and no negative marking

British Cardiovascular Society - EECC

Criterion-referenced

Pass mark is set each year by a standard-setting group, not a fixed percentage

British Cardiovascular Society - EECC

Once a year

EECC is delivered annually through an online proctoring platform (CYIM/ProctorU)

ESC - European Exam in Core Cardiology

ESC and UEMS

Run by the ESC with the UEMS Cardiology Section and national cardiac societies

ESC - European Exam in Core Cardiology

~GBP 510

Example UK fee through the British Cardiovascular Society in 2024

British Cardiovascular Society - EECC

ESC Core Curriculum

Exam content is mapped to the ESC Core Curriculum for the Cardiologist

ESC Core Curriculum for the Cardiologist

The European Exam in Core Cardiology (EECC) is the ESC and UEMS knowledge exam for cardiology trainees, mapped to the ESC Core Curriculum for the Cardiologist. It has 120 best-of-five multiple-choice questions answered over 3 hours, each with a clinical stem and a single question, with no negative marking. The pass mark is criterion-referenced and set each year by a standard-setting group rather than a fixed percentage. The exam is delivered once a year through online proctoring, and fees and eligibility are set by each National or Affiliated Cardiac Society (for example, around GBP 510 in the UK in 2024). This 100-question bank provides original best-of-five practice across coronary disease, heart failure, arrhythmias, valves, imaging, ECG, pharmacology and prevention.

Sample EECC Practice Questions

Try these sample questions to test your EECC 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 with 40 minutes of central crushing chest pain. His ECG shows 2 mm ST-segment elevation in leads II, III and aVF. Which coronary artery is most likely occluded?

A.Left anterior descending artery

B.Right coronary artery

C.Left circumflex artery

D.Left main stem

Explanation: ST elevation in the inferior leads II, III and aVF indicates an inferior STEMI, which is most commonly caused by occlusion of the right coronary artery in right-dominant circulations. Identifying the territory guides urgent reperfusion and anticipation of complications such as bradyarrhythmias.

2In a patient with a confirmed STEMI presenting 90 minutes after symptom onset to a hospital with a 24/7 catheter laboratory, what is the preferred reperfusion strategy?

A.Fibrinolysis followed by transfer

B.Primary percutaneous coronary intervention

C.Conservative medical therapy only

D.Elective angiography in 72 hours

Explanation: For STEMI, primary PCI is the preferred reperfusion strategy when it can be delivered promptly by an experienced team, as it restores flow more reliably and with lower bleeding risk than fibrinolysis. ESC guidelines recommend primary PCI when the expected delay from diagnosis to wire crossing is under 120 minutes.

3Which biomarker is most specific and sensitive for the diagnosis of acute myocardial infarction?

A.Creatine kinase MB

B.High-sensitivity cardiac troponin

C.Myoglobin

D.Lactate dehydrogenase

Explanation: High-sensitivity cardiac troponin (I or T) is the preferred biomarker for diagnosing myocardial infarction because of its high sensitivity and cardiac specificity, allowing rapid rule-in and rule-out algorithms. A rise and/or fall on serial sampling, with at least one value above the 99th percentile, supports acute myocardial injury.

4A patient with NSTEMI is being risk stratified. Which feature most strongly indicates a very-high-risk presentation requiring immediate invasive angiography (within 2 hours)?

A.GRACE score of 110

B.Diabetes mellitus

C.Ongoing haemodynamic instability or cardiogenic shock

D.Troponin rise without ECG changes

Explanation: In NSTE-ACS, very-high-risk criteria such as haemodynamic instability, cardiogenic shock, refractory chest pain, life-threatening arrhythmia or mechanical complications mandate an immediate invasive strategy within 2 hours. These patients have the most to gain from urgent revascularisation.

5A 65-year-old presents with an inferior STEMI and develops hypotension, raised JVP and clear lung fields. Which complication should be suspected?

A.Right ventricular infarction

B.Ventricular septal rupture

C.Acute mitral regurgitation

D.Free wall rupture

Explanation: The triad of hypotension, elevated JVP and clear lung fields in the setting of an inferior STEMI is classic for right ventricular infarction, usually from proximal right coronary occlusion. Management emphasises preload maintenance with fluids and avoidance of nitrates, which can precipitate profound hypotension.

6According to ESC guidance, what is the default duration of dual antiplatelet therapy after PCI for an acute coronary syndrome in a patient at standard bleeding risk?

A.1 month

B.3 months

C.12 months

D.Lifelong

Explanation: The default DAPT duration after PCI for ACS in patients at standard bleeding risk is 12 months, combining aspirin with a P2Y12 inhibitor (preferably ticagrelor or prasugrel). Duration is then individualised, shortened in high bleeding risk or extended in high ischaemic risk.

7A patient with stable angina has angina limiting ordinary activity such as walking one to two blocks. Which Canadian Cardiovascular Society (CCS) class does this describe?

A.CCS class I

B.CCS class II

C.CCS class III

D.CCS class IV

Explanation: CCS class III describes marked limitation of ordinary physical activity, with angina on walking one to two blocks on the level or climbing one flight of stairs at a normal pace. The CCS grading helps quantify symptom burden and guide treatment intensification.

8Which lipid-lowering target does ESC guidance recommend for LDL cholesterol in a patient classed as very high cardiovascular risk?

A.Below 3.0 mmol/L

B.Below 2.6 mmol/L

C.Below 1.8 mmol/L

D.Below 1.4 mmol/L

Explanation: For very-high-risk patients, ESC recommends an LDL cholesterol goal of below 1.4 mmol/L (about 55 mg/dL) and at least a 50% reduction from baseline. High-intensity statins, with ezetimibe and PCSK9 inhibitors if needed, are used to reach this target.

9A 72-year-old with HFrEF (LVEF 30%) is already on an ACE inhibitor, beta-blocker and mineralocorticoid receptor antagonist. Which additional drug class has the strongest evidence to further reduce mortality and heart failure hospitalisation?

A.SGLT2 inhibitor

B.Calcium channel blocker

C.Long-acting nitrate

D.Digoxin

Explanation: SGLT2 inhibitors (dapagliflozin or empagliflozin) are now a foundational pillar of HFrEF therapy, reducing cardiovascular death and heart failure hospitalisation regardless of diabetes status. Together with an ARNI/ACE inhibitor, beta-blocker and MRA, they form the four core drug classes.

10Which natriuretic peptide finding makes a diagnosis of acute heart failure very unlikely in a patient presenting with acute dyspnoea?

A.NT-proBNP above 2000 pg/mL

B.BNP above 400 pg/mL

C.NT-proBNP below 300 pg/mL

D.BNP above 100 pg/mL

Explanation: An NT-proBNP below 300 pg/mL has a high negative predictive value and makes acute heart failure very unlikely in the acute setting. Natriuretic peptides are most useful for ruling out heart failure because of this strong negative predictive value.

About the EECC Exam

The European Exam in Core Cardiology (EECC) is a knowledge-based examination for cardiology trainees, run by the European Society of Cardiology (ESC) together with the UEMS Cardiology Section and participating National and Affiliated Cardiac Societies. It provides a broad, balanced and up-to-date test of the core cardiology knowledge required for independent practice and is mapped to the ESC Core Curriculum for the Cardiologist. The exam consists of 120 best-of-five multiple-choice questions answered over three hours, each with a clinical stem and a single question. It is delivered once a year through an online proctoring platform, with no negative marking and a criterion-referenced pass mark set annually by a standard-setting group. It is intended to complement workplace-based assessments within a comprehensive cardiology training programme.

Assessment

120 single-best-answer multiple-choice questions. Each item presents a clinical stem followed by one question with five options, of which one is the best answer. There is no negative marking.

Time Limit

3 hours (180 minutes) with no scheduled break.

Passing Score

No fixed percentage. The pass mark is criterion-referenced and set each year by a standard-setting group based on the difficulty of the paper.

Exam Fee

Fees are set by each National or Affiliated Cardiac Society, not the ESC. As an example, the UK fee through the British Cardiovascular Society was around GBP 510 in 2024. (European Society of Cardiology (ESC) in conjunction with the UEMS Cardiology Section and National and Affiliated Cardiac Societies)

EECC Exam Content Outline

18%

Coronary artery disease and ACS

Stable coronary artery disease and acute coronary syndromes, including STEMI, NSTEMI and unstable angina. Covers diagnosis, troponin interpretation, antithrombotic and antiplatelet therapy, timing of revascularisation, complications of myocardial infarction and secondary prevention per ESC guidance.

17%

Heart failure and cardiomyopathies

Heart failure across the ejection-fraction spectrum (HFrEF, HFmrEF, HFpEF), guideline-directed medical therapy including the four foundational drug classes, device therapy (CRT, ICD), and dilated, hypertrophic, restrictive and infiltrative cardiomyopathies such as cardiac amyloidosis.

17%

Arrhythmias and ECG interpretation

Supraventricular and ventricular arrhythmias, atrial fibrillation and stroke prevention, bradyarrhythmias and conduction disease, inherited channelopathies, pacing and ICD indications, and systematic 12-lead ECG interpretation.

16%

Valvular, pericardial and congenital disease

Aortic, mitral, tricuspid and pulmonary valve disease and intervention thresholds, infective endocarditis, acute and constrictive pericarditis and tamponade, and common adult congenital heart disease lesions.

14%

Cardiac imaging

Transthoracic and transoesophageal echocardiography, cardiovascular magnetic resonance, cardiac CT and nuclear imaging. Emphasises appropriate use of multimodality imaging, key measurements and characteristic findings in common cardiac conditions.

10%

Prevention, hypertension and pulmonary circulation

Cardiovascular risk assessment and prevention, lipid and blood-pressure management, hypertension and hypertensive emergencies, pulmonary hypertension classification and venous thromboembolism.

Cardiovascular pharmacology

Mechanisms, indications and adverse effects of antiplatelets, anticoagulants, antiarrhythmics, beta-blockers, RAAS inhibitors, SGLT2 inhibitors, diuretics and lipid-lowering agents used across cardiology.

How to Pass the EECC Exam

What You Need to Know

Passing score: No fixed percentage. The pass mark is criterion-referenced and set each year by a standard-setting group based on the difficulty of the paper.
Assessment: 120 single-best-answer multiple-choice questions. Each item presents a clinical stem followed by one question with five options, of which one is the best answer. There is no negative marking.
Time limit: 3 hours (180 minutes) with no scheduled break.
Exam fee: Fees are set by each National or Affiliated Cardiac Society, not the ESC. As an example, the UK fee through the British Cardiovascular Society was around GBP 510 in 2024.

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

EECC Study Tips from Top Performers

1Anchor your revision to the ESC Core Curriculum for the Cardiologist and the most recent ESC Clinical Practice Guidelines, since the exam maps directly to them.

2Because every question is a clinical stem with a single best answer, practise reading the whole vignette and identifying what is actually being asked before looking at the options.

3There is no negative marking, so always answer every question and flag uncertain items to revisit if time allows within the three hours.

4Drill systematic 12-lead ECG interpretation daily; ECG and rhythm questions appear across many topic areas, not just the arrhythmia section.

5Learn the key thresholds that drive ESC decisions, such as intervention criteria for valve disease, anticoagulation by CHA2DS2-VASc, and device indications in heart failure.

6Use large mixed MCQ banks under timed conditions to build pace at roughly 90 seconds per question and to expose gaps across the full curriculum.

Frequently Asked Questions

How many questions are on the EECC and how long is it?

The EECC has 120 single-best-answer multiple-choice questions answered over three hours with no scheduled break. Each question is a clinical stem followed by one question with five options, of which one is the best answer.

Is there negative marking on the EECC?

No. The EECC does not use negative marking, so you should answer every question. The pass mark is criterion-referenced and set each year by a standard-setting group rather than being a fixed percentage.

Who runs the EECC?

The EECC is run by the European Society of Cardiology (ESC) together with the UEMS Cardiology Section and the participating National and Affiliated Cardiac Societies, with independent academic oversight.

How much does the EECC cost?

Fees are set by each National or Affiliated Cardiac Society rather than by the ESC. As an example, the UK fee through the British Cardiovascular Society was around GBP 510 in 2024. Check with your national society for the current local fee.

What syllabus does the EECC follow?

The EECC is mapped to the ESC Core Curriculum for the Cardiologist and draws on the ESC Clinical Practice Guidelines. It tests broad core cardiology knowledge required for independent specialist practice.

Are these official EECC practice questions?

No. These are original OpenExamPrep questions modelled on the EECC best-of-five format and the ESC Core Curriculum. The ESC and national societies provide official information and any official sample material separately.