MS Cardiology Study Guide (2026/2027 Syllabus)
This guide covers the core concepts of Cardiology as per the updated curriculum,
emphasizing pathophysiology, clinical diagnosis, management, and the latest guideline-
directed medical therapy (GDMT).
Section 1: Cardiac Anatomy & Physiology
1. What is the primary pacemaker of the heart, and what is its intrinsic firing rate?
ANSWER ✓ The Sinoatrial (SA) node; intrinsic rate of 60-100 beats per minute.
2. Which coronary artery supplies the inferior wall of the left ventricle?
ANSWER ✓ The right coronary artery (RCA) in a right-dominant circulation.
3. What is the Frank-Starling law of the heart?
ANSWER ✓ It states that the stroke volume of the heart increases in response to an
increase in the volume of blood filling the heart (end-diastolic volume), due to
stretching of the myocardial fibers.
4. Define cardiac output (CO) and list its two primary determinants.
ANSWER ✓ Cardiac output is the volume of blood pumped by the heart per minute. It
is determined by Heart Rate (HR) x Stroke Volume (SV).
5. What is the significance of the "P wave" on an electrocardiogram (ECG)?
ANSWER ✓ It represents atrial depolarization, originating from the SA node.
Section 2: Ischemic Heart Disease
6. What is the classic description of stable angina pectoris?
, ANSWER ✓ Retrosternal chest pain or pressure, often precipitated by exertion or
emotional stress, and relieved by rest or nitroglycerin within minutes.
7. What are the four key components of "Initial Medical Management" for stable
ischemic heart disease, often summarized as "ABCDE"?
ANSWER ✓
o A – Antiplatelet therapy (Aspirin) and Angina treatment
o B – Beta-blocker and Blood pressure control
o C – Cholesterol control (statins) and Cigarette cessation
o D – Diet and Diabetes management
o E – Exercise and Education
8. Differentiate between NSTEMI and STEMI based on ECG findings and pathology.
ANSWER ✓ STEMI (ST-Elevation Myocardial Infarction) typically indicates complete,
transmural ischemia, showing ST-segment elevation. NSTEMI (Non-ST-Elevation
Myocardial Infarction) indicates subendocardial or partial-thickness ischemia, showing
ST-depression or T-wave inversion without elevation, but with elevated cardiac
biomarkers.
9. According to the 2026 guidelines, what is the recommended door-to-balloon
time for a patient presenting with STEMI?
ANSWER ✓ ≤ 90 minutes for percutaneous coronary intervention (PCI).
10. What is the first-line antiplatelet loading dose for a patient undergoing
primary PCI for STEMI?
ANSWER ✓ Aspirin 325 mg (chewed) plus a P2Y12 inhibitor (e.g., Ticagrelor 180 mg or
Prasugrel 60 mg).
11. What are the four universal definitions of Myocardial Infarction (Type 1)?
ANSWER ✓ Detection of a rise and/or fall of cardiac troponin with at least one value
above the 99th percentile URL, plus at least one of: symptoms of ischemia, new ischemic
ECG changes, development of pathological Q waves, imaging evidence of new loss of
viable myocardium, or identification of a coronary thrombus by angiography.
12. What is Prinzmetal's (Variant) Angina?
This guide covers the core concepts of Cardiology as per the updated curriculum,
emphasizing pathophysiology, clinical diagnosis, management, and the latest guideline-
directed medical therapy (GDMT).
Section 1: Cardiac Anatomy & Physiology
1. What is the primary pacemaker of the heart, and what is its intrinsic firing rate?
ANSWER ✓ The Sinoatrial (SA) node; intrinsic rate of 60-100 beats per minute.
2. Which coronary artery supplies the inferior wall of the left ventricle?
ANSWER ✓ The right coronary artery (RCA) in a right-dominant circulation.
3. What is the Frank-Starling law of the heart?
ANSWER ✓ It states that the stroke volume of the heart increases in response to an
increase in the volume of blood filling the heart (end-diastolic volume), due to
stretching of the myocardial fibers.
4. Define cardiac output (CO) and list its two primary determinants.
ANSWER ✓ Cardiac output is the volume of blood pumped by the heart per minute. It
is determined by Heart Rate (HR) x Stroke Volume (SV).
5. What is the significance of the "P wave" on an electrocardiogram (ECG)?
ANSWER ✓ It represents atrial depolarization, originating from the SA node.
Section 2: Ischemic Heart Disease
6. What is the classic description of stable angina pectoris?
, ANSWER ✓ Retrosternal chest pain or pressure, often precipitated by exertion or
emotional stress, and relieved by rest or nitroglycerin within minutes.
7. What are the four key components of "Initial Medical Management" for stable
ischemic heart disease, often summarized as "ABCDE"?
ANSWER ✓
o A – Antiplatelet therapy (Aspirin) and Angina treatment
o B – Beta-blocker and Blood pressure control
o C – Cholesterol control (statins) and Cigarette cessation
o D – Diet and Diabetes management
o E – Exercise and Education
8. Differentiate between NSTEMI and STEMI based on ECG findings and pathology.
ANSWER ✓ STEMI (ST-Elevation Myocardial Infarction) typically indicates complete,
transmural ischemia, showing ST-segment elevation. NSTEMI (Non-ST-Elevation
Myocardial Infarction) indicates subendocardial or partial-thickness ischemia, showing
ST-depression or T-wave inversion without elevation, but with elevated cardiac
biomarkers.
9. According to the 2026 guidelines, what is the recommended door-to-balloon
time for a patient presenting with STEMI?
ANSWER ✓ ≤ 90 minutes for percutaneous coronary intervention (PCI).
10. What is the first-line antiplatelet loading dose for a patient undergoing
primary PCI for STEMI?
ANSWER ✓ Aspirin 325 mg (chewed) plus a P2Y12 inhibitor (e.g., Ticagrelor 180 mg or
Prasugrel 60 mg).
11. What are the four universal definitions of Myocardial Infarction (Type 1)?
ANSWER ✓ Detection of a rise and/or fall of cardiac troponin with at least one value
above the 99th percentile URL, plus at least one of: symptoms of ischemia, new ischemic
ECG changes, development of pathological Q waves, imaging evidence of new loss of
viable myocardium, or identification of a coronary thrombus by angiography.
12. What is Prinzmetal's (Variant) Angina?
