Free Practice Questions for CMC Cardiología

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Exam Review

Key Facts: CMC Cardiología Exam

24 Oct 2026

Theoretical written exam date

Consejo Mexicano de Cardiología Convocatoria 2026

22–30 Oct 2026

Practical exam dates (assigned in Mexico City)

Consejo Mexicano de Cardiología Convocatoria 2026

4–30 Aug 2026

Candidate registration window via SIGME

Consejo Mexicano de Cardiología Convocatoria 2026

2 stages

Mandatory evaluation stages (theoretical and practical)

Consejo Mexicano de Cardiología

5 years

Certification validity under CONACEM

CONACEM Guidelines

The CMC certification is the CONACEM-recognized board certification for clinical cardiology in Mexico: a theoretical exam (24 October 2026) plus a practical exam (22–30 October 2026) in Mexico City, both of which must be passed.

Sample CMC Cardiología Practice Questions

Try these sample questions to review concepts for the CMC Cardiología exam. 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 rural primary healthcare center in Mexico with severe retrosternal crushing chest pain of 45 minutes duration. An electrocardiogram obtained within 8 minutes shows 3.5 mm ST-segment elevation in leads V1–V4 with reciprocal depressions in leads II, III, and aVF. The nearest percutaneous coronary intervention (PCI) capable hospital is 140 minutes away by road. Which of the following is the most appropriate reperfusion strategy according to clinical practice guidelines?

A.Administer intravenous fibrinolytic therapy immediately at the presenting center within 10 minutes

B.Transfer the patient immediately for primary PCI without administering fibrinolytic therapy

C.Administer dual oral antiplatelet therapy and observe for 60 minutes before deciding on transfer

D.Perform urgent coronary CT angiography to confirm proximal left anterior descending coronary occlusion

Explanation: In patients with acute ST-segment elevation myocardial infarction (STEMI) presenting within 12 hours of symptom onset, primary PCI is the preferred reperfusion strategy only if the anticipated delay from STEMI diagnosis to wire crossing is ≤120 minutes. When the expected transfer time exceeds 120 minutes (here, transfer alone is 140 minutes), immediate fibrinolysis should be administered within 10 minutes of diagnosis ('door-to-needle' time) provided there are no contraindications, followed by transfer to a PCI-capable center for rescue PCI or routine angiography (pharmacoinvasive strategy).

2A 64-year-old male with a history of an ischemic cerebrovascular accident 2 years ago undergoes successful primary percutaneous coronary intervention with a drug-eluting stent for an acute inferior STEMI. Echocardiography demonstrates a left ventricular ejection fraction of 48%. Which P2Y12 platelet receptor inhibitor is explicitly contraindicated in this patient?

A.Clopidogrel

B.Prasugrel

C.Ticagrelor

D.Cangrelor

Explanation: Prasugrel is a potent third-generation thienopyridine P2Y12 inhibitor. In the TRITON-TIMI 38 trial, patients with a previous history of stroke or transient ischemic attack (TIA) experienced a net clinical harm with prasugrel due to a significantly increased risk of major bleeding and fatal intracranial hemorrhage. Consequently, a prior history of stroke or TIA represents an absolute contraindication to prasugrel.

3On day 4 following an extensive anterior myocardial infarction, a 69-year-old woman suddenly develops respiratory distress, cool extremities, and a blood pressure of 82/50 mmHg. Cardiac auscultation reveals a loud, harsh, pansystolic murmur loudest at the lower left sternal border accompanied by a palpable thrill. Right heart catheterization reveals an oxygen saturation of 62% in the right atrium and 84% in the right ventricle. Which mechanical complication has occurred?

A.Acute free wall rupture with hemopericardium

B.Acute papillary muscle rupture with mitral regurgitation

C.Ventricular septal rupture

D.Left ventricular pseudoaneurysm formation

Explanation: Ventricular septal rupture (VSR) is a severe mechanical complication of transmural myocardial infarction, typically occurring 3 to 7 days post-MI. It classically presents with sudden hemodynamic collapse, a harsh pansystolic murmur with a palpable thrill at the left sternal border, and an oxygen saturation step-up (≥7–10%) between the right atrium and the right ventricle on pulmonary artery catheterization, confirming a left-to-right intracardiac shunt.

4A 71-year-old male presents on day 3 after an acute inferior STEMI with acute pulmonary edema, diaphoresis, and cardiogenic shock. Bedside echocardiography demonstrates a hyperdynamic left ventricle, a flail posterior mitral valve leaflet, and torrential eccentric mitral regurgitation. An emergency surgical consult is requested. Which coronary artery branch supplies the posteromedial papillary muscle that predisposes it to rupture in this setting?

A.Dual blood supply from the left anterior descending and circumflex arteries

B.Exclusively the first septal perforator branch of the LAD

C.Exclusively the diagonal branch of the left anterior descending artery

D.Single blood supply from the posterior descending artery (usually from the right coronary artery)

Explanation: The posteromedial papillary muscle has a solitary blood supply derived from the posterior descending artery (PDA), which arises from the right coronary artery in right-dominant systems (85% of individuals) or the circumflex artery in left-dominant systems. Because it lacks dual collateral perfusion—unlike the anterolateral papillary muscle, which receives dual perfusion from both the LAD and LCx—it is 6 to 12 times more prone to ischemic necrosis and complete rupture during inferior or posterior infarction.

5A 56-year-old male is evaluated in the emergency room for chest pain. Electrocardiogram reveals ST-segment elevation in leads II, III, and aVF. Shortly after administration of sublingual nitroglycerin, his blood pressure drops from 124/76 mmHg to 72/40 mmHg, heart rate is 58 bpm, and physical examination reveals marked jugular venous distension with completely clear lung fields on auscultation. What is the immediate first-line management step?

A.Administer rapid intravenous isotonic crystalloid boluses and discontinue nitrates

B.Administer intravenous furosemide bolus 80 mg to reduce central venous pressure

C.Start a high-dose infusion of intravenous nitroglycerin to relieve ongoing coronary spasm

D.Infuse intravenous labetalol to control the underlying hypertensive response

Explanation: This patient has an acute inferior STEMI with right ventricular (RV) involvement. The RV becomes stiff and dilates, depending critically on adequate preload to maintain forward cardiac output. Vasodilators (such as nitrates) and diuretics dramatically reduce venous return, precipitating profound arterial hypotension and shock. The immediate treatment is volume expansion with intravenous crystalloid boluses (typically 1–2 L) to restore RV preload and maintain cardiac output while urgent catheterization is organized.

6During elective coronary angiography for chronic coronary syndrome, a 62-year-old patient is found to have an intermediate 55% stenosis in the mid-left anterior descending artery. Pressure wire evaluation is performed under maximal hyperemia induced by intravenous adenosine. Which fractional flow reserve (FFR) or instantaneous wave-free ratio (iFR) value confirms hemodynamically significant ischemia requiring revascularization?

A.FFR ≤ 0.90 or iFR ≤ 0.95

B.FFR ≤ 0.80 or iFR ≤ 0.89

C.FFR ≤ 0.70 or iFR ≤ 0.80

D.FFR ≤ 0.60 or iFR ≤ 0.75

Explanation: Fractional flow reserve (FFR) is the ratio of maximum blood flow in a stenotic artery to normal maximum flow. Multiple landmark clinical trials (FAME, DEFER) established an FFR threshold of ≤0.80 under maximal hyperemia (adenosine) as indicative of lesion-specific ischemia benefiting from revascularization. Instantaneous wave-free ratio (iFR) is a resting index measured during the wave-free diastolic period; an iFR of ≤0.89 is non-inferior to FFR (DEFINE-FLAIR, iFR-SWEDEHEART) for guiding revascularization decisions.

7An 80-year-old female with moderate renal impairment (eGFR 38 mL/min/1.73 m²) is admitted with non-ST-elevation myocardial infarction (NSTE-ACS). She was treated initially with subcutaneous fondaparinux 2.5 mg daily. On day 2, she develops recurrent chest pain at rest, and urgent coronary angiography with intended PCI is planned. Which parenteral anticoagulant strategy must be implemented in the catheterization laboratory during the procedure?

A.Continue fondaparinux alone without adding any other anticoagulant

B.Switch to low-molecular-weight heparin enoxaparin at a full therapeutic dose of 1 mg/kg IV bolus

C.Administer a weight-adjusted intravenous bolus of unfractionated heparin (UFH)

D.Administer intravenous bivalirudin along with a high-dose fondaparinux bolus

Explanation: In the OASIS-5 trial, fondaparinux was associated with a 50% reduction in major bleeding compared to enoxaparin in NSTE-ACS, but it showed an increased risk of catheter-related thrombosis during PCI. Therefore, clinical guidelines mandate that when a patient treated with fondaparinux undergoes PCI, an intravenous bolus of unfractionated heparin (UFH, typically 70–85 IU/kg, or 50–60 IU/kg with GP IIb/IIIa inhibitors) must be added during the catheterization procedure to prevent catheter thrombosis.

8A 36-year-old postpartum woman (4 weeks after uncomplicated delivery) presents with sudden-onset typical chest pain and elevated cardiac troponin. Urgent coronary angiography reveals smooth, tapering narrowing without atherosclerotic changes, confirming Type 2 spontaneous coronary artery dissection (SCAD) in the mid-to-distal LAD. She is currently pain-free, hemodynamically stable, with TIMI 3 distal flow and LVEF 52%. What is the recommended management strategy?

A.Emergency coronary artery bypass grafting (CABG) with left internal mammary artery

B.Immediate implantation of multiple overlapping drug-eluting stents across the entire dissected segment

C.Aggressive balloon angioplasty followed by bioresorbable vascular scaffold placement

D.Conservative medical management with beta-blockers and observation

Explanation: In spontaneous coronary artery dissection (SCAD), observational studies have demonstrated that conservative medical management leads to spontaneous angiographic healing in >70–90% of cases within several months. Routine PCI in SCAD is associated with high technical failure rates, risk of extending the intramural hematoma, and vessel occlusion. Conservative therapy (primarily beta-blockade to reduce shear stress, plus antiplatelet therapy) is the first-line standard of care for hemodynamically stable patients with preserved distal flow.

9A 48-year-old female presents with acute chest pain, elevated high-sensitivity troponin I (1,450 ng/L), and anterolateral T-wave inversions. Coronary angiography reveals completely normal coronary arteries with zero percent stenosis in all vessels (MINOCA). What diagnostic imaging modality is considered the gold standard next step to establish the underlying etiology?

A.Cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement

B.Transesophageal echocardiography with agitated saline bubble study

C.Rest/stress technetium-99m sestamibi SPECT myocardial perfusion imaging

D.Coronary computed tomography angiography with plaque characterization

Explanation: In patients fulfilling criteria for Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA), cardiac magnetic resonance (CMR) imaging is the cornerstone diagnostic modality (Class I recommendation). CMR accurately identifies the underlying etiology in up to 85% of cases by distinguishing between true ischemic myocardial infarction (subendocardial or transmural late gadolinium enhancement [LGE] in a coronary territory), acute myocarditis (subepicardial or mid-wall LGE with myocardial edema), and Takotsubo cardiomyopathy (apical ballooning with edema and absence of LGE).

10A 67-year-old postmenopausal woman is brought to the emergency department with acute retrosternal chest pain and dyspnea 2 hours after learning of a sudden family tragedy. The ECG reveals anterior ST-segment elevation. Coronary angiography demonstrates angiographically normal coronaries without rupture or thrombus. Left ventriculography displays apical ballooning with hypercontractile basal segments and an ejection fraction of 35%. Which of the following is characteristic of this condition?

A.Permanent irreversible transmural necrosis requiring long-term ICD implantation

B.Transient left ventricular systolic dysfunction that typically recovers completely over weeks to months

C.Mandatory lifelong therapy with warfarin with target INR 2.5–3.5

D.High incidence of acute aortic dissection originating in the ascending aorta

Explanation: Takotsubo cardiomyopathy (stress-induced cardiomyopathy or broken-heart syndrome) is characterized by transient left ventricular systolic dysfunction, classic apical/mid-ventricular akinesis ('apical ballooning'), and hyperdynamic basal contraction, triggered by intense emotional or physical stress with catecholamine surge. A hallmark of Takotsubo is that left ventricular systolic function typically recovers completely or nearly completely within 4 to 8 weeks with supportive medical care.

About the CMC Cardiología Exam

Independent practice resource by OpenExamPrep for the written theoretical certification examination of the Consejo Mexicano de Cardiología A.C. (CMC). The official CMC certification process includes a theoretical examination on 24 October 2026 and a practical examination at an assigned hospital on a date between 22 and 30 October 2026 in Mexico City; both must be passed. This question bank is an independent English-language MCQ study adaptation focused on clinical scenarios, hemodynamics, electrocardiography, pharmacotherapy, and guideline-directed practice, built on current ESC and ACC/AHA guidelines and standard cardiology references because the CMC publishes no temario. It is not an official examination or translation of the Spanish-language exam and does not simulate the practical exam stage.

Exam sponsor: Consejo Mexicano de Cardiología A.C. (CMC). The requirements and fees below concern the certification or admission exam, separate from our free practice resources.

Assessment

The certification process comprises two mandatory stages: a theoretical examination and a practical examination held at a hospital site assigned by the council. Both stages must be passed; item count, duration and pass mark are not published.

Time Limit

Not published

Passing Score

not-published

Exam / Certification Fees

Not published

Exam sponsor website

Fees, eligibility, and exam policies can change. Confirm them with the exam sponsor before applying or paying.

Official sources

Consejo Mexicano de Cardiología A.C. — Convocatoria y Certificación · Source checked 2026-09-29Official portal providing convocatorias, examination dates (theoretical and practical), SIGME registration instructions, and candidate requirements
CONACEM — Catálogo de Consejos de Especialidades Médicas · Source checked 2026-09-29Official registry of specialty councils holding idoneidad under Articles 81 and 272 Bis of the Mexican Ley General de Salud

Our practice resources: topics covered

We aim to reflect publicly available exam outlines and topic information in our study resources. Coverage, format, and difficulty may differ from the actual exam, and we cannot guarantee that every detail is accurate or current. Confirm exam requirements, fees, and policies with the official exam sponsor.