The exam blueprint
The course follows the ABIM Cardiovascular Disease Certification Examination blueprint (May 2026), published by ABIM, in its order: one lesson per topic it lists. The percentages are ABIM's share of a typical exam. ABIM's blueprint (PDF).
The exam has two parts: a full day of up to 240 single-best-answer questions (categories 1 to 11) and a half day of electrocardiograms, echocardiograms and coronary angiograms (categories 12 to 14).
1. Arrhythmias
15%-
Atrioventricular conduction disease
<2%First-degree AV block · Second-degree AV block · Complete (third-degree) AV block · Left bundle branch block · Right bundle branch block · Left anterior fascicular block · Left posterior fascicular block
-
Sinus node dysfunction
<2%Sinus bradycardia · Sinus pauses · Bradycardia-tachycardia syndrome
-
Supraventricular arrhythmias
2%Atrioventricular nodal reentrant tachycardia · Pre-excitation syndromes (including Wolff-Parkinson-White) · Atrioventricular reciprocating tachycardia
-
Ventricular arrhythmias
2%Ventricular tachycardia, monomorphic · Ventricular tachycardia, polymorphic · Ventricular fibrillation (including idiopathic and non-idiopathic varieties) · Premature ventricular complexes
-
Atrial arrhythmias
3.5%Atrial fibrillation · Atrial flutter · Atrial tachycardia · Ectopic atrial rhythms · Premature atrial contractions
-
Channelopathies
<2%Long Q-T, congenital or acquired · Brugada syndrome · Early repolarization
-
Sudden cardiac death
<2% -
Syncope
<2% -
Pacemaker and ICD function
<2% -
Antiarrhythmic drug effects
<2%
2. Coronary Artery Disease
21.5%-
Angina pectoris
5%Unstable angina · Vasospastic angina · Angina equivalent · Exertional angina · Angina with microvascular disease
-
Chronic ischemic heart disease
5%Coronary atherosclerosis · Remote myocardial infarction · Aneurysm of the heart · Coronary artery aneurysm · Silent myocardial ischemia
-
Acute myocardial infarction
9.5%STEMI of the anterior wall · STEMI of the inferior wall · STEMI of the lateral wall · STEMI of the posterior wall (including inferoposterior wall) · Type I Non-STEMI · Type II myocardial infarction · Spontaneous coronary artery dissection · STEMI, other
-
Early complications following acute myocardial infarction
<2%Ventricular septal rupture · Rupture of the cardiac wall · Rupture of papillary muscle · Postinfarction angina · Postinfarction arrhythmias · Left ventricular pseudoaneurysm · Dynamic left ventricular outflow tract obstruction · Postinfarction systolic heart failure
-
Atypical angina or noncardiac chest pain
<2%
3. Heart Failure and Cardiomyopathy
17%-
Heart failure
7%Acute decompensated ventricular failure · Systolic heart failure (heart failure with reduced ejection fraction) · Diastolic heart failure (heart failure with preserved ejection fraction) · Heart failure with improved ejection fraction · Cardiogenic shock
-
Cardiomyopathies
8%Dilated cardiomyopathies · Hypertrophic cardiomyopathies · Restrictive and infiltrative cardiomyopathies · Chemotherapy-related cardiomyopathy · Stress-induced cardiomyopathy (Takotsubo syndrome) · Myocarditis · Noncompaction cardiomyopathy · Arrhythmogenic right ventricular dysplasia
-
Transplanted heart
<2% -
Mechanical circulatory support
<2%
4. Valvular Disease
15%-
Mitral valve disorders
5.5%Mitral valve regurgitation, native · Mitral valve stenosis, native · Mitral valve prolapse, native · Prosthetic mitral valve · Systolic anterior motion
-
Aortic valve disorders
4.5%Aortic valve regurgitation, native · Aortic valve stenosis, native · Prosthetic aortic valve
-
Tricuspid valve disorders
<2%Tricuspid valve regurgitation, native · Tricuspid valve stenosis, native · Prosthetic tricuspid valve
-
Pulmonary valve disorders
<2%Pulmonary valve regurgitation, native · Pulmonary valve stenosis, native · Prosthetic pulmonary valve
-
Endocarditis
2% -
Cardiac murmurs and other cardiac sounds
<2%
5. Pericardial Disease
4%-
Acute pericarditis
<2% -
Chronic pericarditis (including relapsing)
<2% -
Pericardial constriction and effusion
<2%Pericardial effusion · Cardiac tamponade · Constrictive pericarditis · Effusive-constrictive pericarditis
-
Abnormalities of the pericardium
<2%
6. Congenital Heart Disease
5%-
Congenital malformations of cardiac chambers and connections
<2%Complete transposition of the great vessels · Corrected transposition of the great vessels · Tricuspid atresia · Anomalous origin or course of coronary artery · Tetralogy of Fallot
-
Congenital malformations of cardiac septa
<2%Ventricular septal defect · Atrial septal defect · Patent foramen ovale · Atrioventricular septal defect
-
Congenital malformations of pulmonary and tricuspid valves
<2% -
Congenital malformations of aortic and mitral valves
<2% -
Other congenital malformations of the heart
<2% -
Congenital malformations of the great arteries
<2%Patent ductus arteriosus · Coarctation of the aorta · Aneurysm of the sinus of Valsalva · Congenital malformation of the aortic arch · Pulmonary artery malformation
-
Congenital malformations of the great veins
<2%Persistent left superior vena cava · Anomalous pulmonary venous connections
-
Congenital disorders with cardiovascular implications
<2% -
Eisenmenger syndrome
<2%
7. Vascular Diseases
6%-
Cerebrovascular diseases
<2%Cerebral infarction, including cardiovascular manifestations · Extracranial cervical (carotid and vertebral) · Subclavian steal syndrome with vertebral artery steal · Carotid artery dissection
-
Diseases of the arteries, arterioles, and capillaries
3%Peripheral atherosclerosis · Aortic aneurysm and dissection · Raynaud's phenomenon · Thromboangiitis obliterans (Buerger's disease) · Claudication · Acute limb ischemia · Critical limb ischemia · Atheroembolism · Septic arterial embolism · Polyarteritis nodosa · Mucocutaneous lymph node syndrome (Kawasaki disease) · Takayasu arteritis · Giant cell arteritis with polymyalgia rheumatica · Mesenteric arterial insufficiency · Subclavian steal syndrome with internal mammary artery steal · Fibromuscular dysplasia
-
Diseases of the veins, lymphatic vessels, and lymph nodes
<2%Deep vein thrombosis · Portal vein thrombosis · Iliac vein compression syndrome (May-Thurner syndrome) · Varicose veins of the lower extremities · Chronic venous insufficiency · Chronic idiopathic venous hypertension · Lymphedema
8. Systemic Hypertension and Hypotension
7.5%-
Hypertensive diseases
7%Essential (primary) hypertension · Hypertensive heart disease · Hypertensive chronic kidney disease · Severe or resistant hypertension · Urgent/emergent hypertension · Secondary hypertension · Hypertension in pregnancy
-
Hypotensive diseases
<2%
9. Pulmonary Circulation Disorders
3%-
Pulmonary embolism
<2%Pulmonary embolism with acute cor pulmonale · Pulmonary embolism without acute cor pulmonale · Chronic pulmonary embolism
-
Pulmonary hypertension
<2%Pulmonary arterial hypertension (WHO Group 1) · Pulmonary hypertension associated with other diseases (WHO Groups 2–5)
10. Systemic Disorders Affecting the Circulatory System
4%-
Musculoskeletal and connective tissue
<2% -
Endocrine, nutritional, metabolic, and hematologic disorders
<2%Dyslipidemias · Diabetes · Obesity · Electrolyte and endocrine abnormalities · Hematologic disorders
-
Renal disorders
<2% -
Injury and poisoning
<2%Toxic effects of alcohol · Toxic effects of tobacco and nicotine · Toxic effects of drugs other than alcohol and tobacco · Anaphylactic shock · Angioedema
-
Cardio-Oncology
<2%Cardiovascular effects of pharmacological cancer therapy · Cardiovascular effects of radiation therapy · Neoplasms
11. Normal Cardiovascular Anatomy and Physiology
2%-
Normal Cardiovascular Anatomy and Physiology
2%
12. Electrocardiograms
48%-
General features
2.5% -
P wave abnormalities
<2% -
Rhythms
10.5%Atrial rhythms · Atrioventricular junctional rhythms · Ventricular rhythms
-
Atrioventricular conduction
6% -
Abnormal QRS voltage or axis
3% -
Ventricular hypertrophy
<2% -
Intraventricular conduction
4.5% -
Myocardial infarction
7.5% -
S-T, T, and U wave abnormalities
4.5% -
Clinical disorders
5% -
Pacemaker function
3%
13. Echocardiograms
37%-
Left ventricular size, function, and structure
11% -
Right ventricular size, function, and structure
<2% -
Diseases of the atria
<2% -
Valvular heart disease
11% -
Cardiomyopathy
4% -
Systemic disease
<2% -
Pulmonary disease
<2% -
Diseases of the aorta
2% -
Pericardial and pleural diseases
3% -
Congenital heart disease
<2%
14. Coronary Angiograms
15%-
Normal
<2% -
Stenoses
3%Insignificant stenosis · Moderate stenosis · Severe stenosis · Total occlusion
-
Filled by collateral vessels
<2% -
Spasm
<2% -
Thrombus
<2% -
Myocardial bridge
<2% -
Anomalous origin
<2% -
Fistula
<2% -
Aneurysm
<2% -
Bypass graft
<2% -
Dissection
<2% -
Stents
<2%