1
Curriculum
DM Cardiology
Index
1. Goals
2. Objectives
3. Syllabus
4. Teaching Programme
5. Schedule of posting
6. Research Projects
7. Assessment
8. Job responsibilities
9. Suggested Books & Journals
10. Model Test Papers
Curriculum DM (Cardiology)
2
Curriculum
DM Cardiology
The infrastructure and faculty of the department will be as per MCI guidelines.
1. Goals
The goal of DM course is to produce a competent cardiologist who:
Recognizes the health needs of patients and carries out professional obligations
in keeping the principles of National Health policy and professional ethics
Has acquired the competencies pertaining to neurology that are required to be
practiced in the community and at all levels of health care system
Has acquired skills in effectively communicating with the patients, family and the
community
Is aware of the contemporary advances and developments in medical sciences
Acquires a spirit of scientific enquiry and is oriented to principles of research
methodology
Has acquired skills in educating medical and paramedical professionals
2. Objectives
At the end of the DM course in Cardiology, the student should be able to:
Recognize the key importance of medical problems in the context in the health
priority of the country;
Practice the specialty of cardiology in keeping with the principles of professional
ethics.
Identify social, economic, environmental, biological and emotional determinants
of adult cardiovascular diseases and know the therapeutic, rehabilitative,
preventive and promotion measures to provide holistic care to all patients.
Take detailed history, perform full physical examination and make a clinical
diagnosis.
Perform and interpret relevant investigations (Imaging and Laboratory).
Perform and interpret important diagnostic procedures.
Diagnose cardiovascular illnesses based on the analysis of history, physical
examination and investigative work up;
Plan and deliver comprehensive treatment for illness using principles of rational
drug therapy.
Plan and advice measures for the prevention of cardiovascular diseases.
Plan rehabilitation of adults suffering from chronic illness, and those with special
needs;
Manage cardiological emergencies efficiently;
Curriculum DM (Cardiology)
3
Demonstrate skills in documentation of case details, and of morbidity and
mortality data relevant to the assigned situation;
Demonstrate empathy and humane approach towards patients and their families
and respect their sensibilities;
Demonstrate communication skills of a high order in explaining management and
prognosis, providing counseling and giving health education messages to
patients, families and communities.
Develop skills as a self- directed learner, recognize continuing educational
needs; use appropriate learning resources, and critically analyze published
literature in order to practice evidence-based medicine;
Demonstrate competence in basic concepts of research methodology and
epidemiology;
Facilitate learning on MD residents, medical/nursing students, practicing
physicians, paramedical health workers and other providers as a teacher- trainer;
Play and assigned role in the implementation of national health programs,
effectively and responsibly;
Organize and supervise the desired managerial and leadership skills;
Function as a productive member of a team engaged in health care, research
and education.
3. Syllabus
3.1 Theory
The syllabus should include the cardinal manifestations, definition, epidemiology,
etiopathogenesis, genetics, clinical presentation, complications, differential diagnosis,
investigations, treatment and prevention and prognosis of all cardio-vascular diseases.
In addition the candidate should be well versed with all the common and important
pediatric cardiological diseases. It should also cover the recent advances that have
occurred in the field of cardiology.
Fundamentals of Cardiovascular Disease
Global Burden of Cardiovascular Disease, Heart Disease in Varied Populations,
Economics and Cardiovascular Disease, Clinical Decision-Making in Cardiology,
Measurement and Improvement of Quality of Cardiovascular Care, The Principles of
Drug Therapy.
Molecular Biology and Genetics
Molecular Biology, Genomics and Proteomics in Cardiovascular Disease, Genetics
and Cardiovascular Disease, Genetics of Cardiac Arrhythmias, Genetics of
Myocardial Disease.
Evaluation of the Patient
The History and Physical Examination: An Evidence-Based Approach,
Electrocardiography, Exercise Stress Testing, Echocardiography, Genetics of
Myocardial Disease, Genetics of Myocardial Disease, The Chest Radiograph in
Cardiovascular Disease, Nuclear Cardiology, Cardiovascular Magnetic Resonance,
Curriculum DM (Cardiology)
4
Computed Tomography of the Heart, Cardiac Catheterization, Coronary
Angiography and Intravascular Ultrasound Imaging.
Heart Failure
Mechanisms of Cardiac Contraction and Relaxation, Pathophysiology of Heart
Failure, Clinical assessment, Acute Heart Failure, Systolic Heart Failure, Heart
Failure w/Preserved Systolic Fx, Surgical management of Heart Failure, Assisted
Circulation in the treatment of Heart Failure, Emerging therapies for Heart Failure,
Care of Patients with End-Stage Heart Disease.
Arrhythmias, Sudden Death, and Syncope
Genesis of Cardiac Arrhythmias: Electrophysiological Considerations, Diagnosis of
Cardiac Arrhythmias, Therapy for Cardiac Arrhythmias, Cardiac Pacemakers and
Cardioverter-Defibrillators, Specific Arrhythmias: Diagnosis and Treatment, Cardiac
Arrest and Sudden Cardiac Death, Hypotension and Syncope.
Preventive Cardiology
The Vascular Biology of Atherosclerosis, Risk Factors for Atherothrombotic Disease,
Systemic Hypertension: Mechanisms and Diagnosis, Systemic Hypertension:
Therapy, Lipoprotein Disorders and Cardiovascular Disease, The Metabolic
Syndrome, Diabetes Mellitus, and Atherosclerotic Vascular Disease, Nutrition and
Cardiovascular Disease, Primary and Secondary Prevention of Coronary Heart
Disease, Comprehensive Rehabilitation of Patients with Cardiovascular Disease,
Complementary and Alternative Approaches to Management.
Atherosclerotic Cardiovascular Disease
Coronary Blood Flow and Myocardial Ischemia, Approach to the Patient with Chest
Pain, ST-Elevation Myocardial Infarction: Pathology, Pathophysiology, and Clinical
Features, ST-Elevation Myocardial Infarction: Management, Primary Percutaneous
Coronary Intervention in the Management of Acute Myocardial Infarction, Unstable
Angina and Non-ST Elevation Myocardial Infarction, Chronic Coronary Artery
Disease, Percutaneous Coronary and Valvular Intervention, Diseases of the Aorta
Peripheral Arterial Diseases, Prevention and Management of Stroke, Endovascular
Treatment of Noncoronary Obstructive Vascular Disease, Diabetes and Heart
Disease.
Diseases of the Heart, Pericardium, and Pulmonary Vasculature Bed
Congenital Heart Disease, Valvular Heart Disease, Infective Endocarditis, The
Dilated, Infiltrative and Restrictive Cardiomyopathies, Hypertrophic
Cardiomyopathies, Myocarditis, Cardiovascular Abnormalities in HIV-Infected
Individuals, Toxins and the Heart, Primary Tumors of the Heart, Pericardial
Diseases, Traumatic Heart Disease, Pulmonary Embolism, Pulmonary
Hypertension, Sleep Disorders and Cardiovascular Disease.
Cardiovascular Disease in Special Populations
Curriculum DM (Cardiology)
5
Cardiovascular Disease in the Elderly, Cardiovascular Disease in Women,
Pregnancy and Cardiovascular Disease, Sports Cardiology, Medical Management of
the Patient Undergoing Cardiac Surgery, Anesthesia and Noncardiac Surgery in
Patients with Heart Disease.
Cardiovascular Disease and Disorders of Other Organs
Endocrine Disorders and Cardiovascular Disease, Hemostasis, Thrombosis,
Fibrinolysis, and Cardiovascular Disease, Rheumatic Fever, Rheumatic Diseases
and the Cardiovascular System, The Patient with Cardiovascular Disease and
Cancer, Psychiatric Behavioral Aspects of Cardiovascular Disease, Neurological
Disorders and Cardiovascular Disease, Interface Between Renal Disease and
Cardiovascular Illness, Cardiovascular Manifestations of Autonomic Disorders.
3.2. Practical:
History, examination and writing of records:
• History taking should include the background information, presenting complaints
and the history of present illness, history of previous illness, family history, social
and occupational history and treatment history.
• Detailed physical examination should include general physical and CVS
examination
• Skills in writing up notes, maintaining problem-oriented medical records (POMR),
progress notes, and presentation of cases during ward rounds, planning
investigation and making a treatment plan should be taught.
• The resident should fortify the skills of hemodynamic monitoring in emergency
situations and should learn procedures like arterial line insertion, temporary
venous pacing, central line insertion, pericardiocentesis, intra aortic balloon
pump insertion, swan ganz catheter insertion etc.
• The resident should assist and perform procedures like coronary angiography,
percutaneous coronary angioplasty, balloon valvoloplasty, cardiac catheterization
of congenital heart disease patients, temporary pacemaker, permanent
pacemaker, Electrophysiological diagnosis and management of arrhythmias,
AICD, Bi-ventricular pacemaker, IABP insertion etc.
• Ability to perform echo-cardiograms of adults, adolescents and infants under
direct supervision. He should observe transesophageal echo’s and should also
master the skills of performing and interpreting stress tests and holter monitoring.
3.3. Clinical Teaching
General physical and CVS examination should be mastered. The resident should
be able to analyse the history and correlate it with clinical findings with the assistance of
basic investigations like ECG, X-Ray etc. Besides, during the bed side rounds he/she
should learn to improvise on management skills, haemodynamic monitoring, fluid
balance and identification of cardiac emergencies like tamponade, arrhythmias etc.
4. Teaching Programme
Curriculum DM (Cardiology)
6
4.1 General Principles
Acquisition of practical competencies being the keystone of postgraduate
medical education, postgraduate training is skills oriented.
Learning in postgraduate program is essentially self-directed and primarily
emanating from clinical and academic work. The formal sessions are merely meant to
supplement this core effort.
4.2 Teaching Sessions
The teaching methodology consists of bedside discussions, ward rounds, case
presentations, clinical grand rounds, statistical meetings, journal club, lectures and
seminars. Along with these activities, trainees should take part in inter-departmental
meetings i.e clinico-pathological and clinico-radiological meetings that are organized
regularly.
Trainees are expected to be fully conversant with the use of computers and be
able to use databases like the Medline, Pubmed etc.
They should be familiar with concept of evidence based medicine and the use of
guidelines available for managing various diseases.
4.3 Teaching Schedule
Following is the suggested weekly teaching programme in the Department of
Cardiology:
Sr. No. Description Frequency
1. Bedside clinical case Once a week
2. Seminar / Journal club Once a week
3. will take PG/Undergraduate ward Once a week
4. Cath conference Once a week
5. Session on ECG’s/X-ray’s Once month
6. Session on echocardiography / TMT/ Holter Once a month
There should be 3 teaching sessions at least of one hour per week duration.
Each unit should have regular teaching rounds for residents posted in that unit. The
rounds should include bedside case discussions, file rounds (documentation of case
history and examination, progress notes, round discussions, investigations and
management plan), interesting and difficult case unit discussions.
Central hospital teaching sessions will be conducted regularly and DM residents
would present interesting cases, seminars and take part in clinico-pathological case
discussions.
4.4 Conferences and Papers
A resident must attend at least one conference per year.
One paper must be presented in at least 3 years.
5. Schedule of posting
Curriculum DM (Cardiology)
7
Ward & ICCU’s Duties : 12 months
Duties should include diagnostic case workup and day to day management of common
cases (angina, myocardial infarction, rheumatic heart disease, hypertension, congestive
heart failure, congenital heart disease,). The resident should acquire the expertise /
knowledge to diagnose and manage the cardiac emergencies (acute myocardial
infarction and its complications, LVF, common arrhythmias, cardiogenic shock,
pericardial tamponade etc).
Cardiac Emergency posting : 6 months
The resident should learn prompt diagnosis and management of cardiac emergencies.
He/she should fortify the skills of hemodynamic monitoring in emergency situations and
should learn procedures like arterial line insertion, temporary venous pacing, central line
insertion, pericardiocentesis, intra aortic balloon pump insertion, swan ganz catheter
insertion etc.
Cath Lab posting : 8 months
The resident should acquaint himself with the pre, peri and post procedural
management of patients to be taken up for intervention in a cath lab. He/she should
assist and perform procedures like coronary angiography, percutaneous coronary
angioplasty, balloon valvoloplasty, cardiac catheterization of congenital heart disease
patients, temporary pacemaker, permanent pacemaker, Electrophysiological diagnosis
and management of arrhythmias, AICD, Bi-ventricular pacemaker, IABP
insertion etc.
Non-invasive lab posting : 8 months
The resident should learn the principles and fundamentals of echocardiography. He
should be able to perform echo-cardiograms of adults, adolescents and infants under
direct supervision. He should observe transesophageal echo’s and should also master
the skills of performing and interpreting stress tests and holter monitoring.
Cardiac surgery posting : 2 months
The resident should learned pre operative preparation and management of post
operative recovery patients. He/She should have seen CABG, valve replacement,
congenital heart disease surgery and aortic surgery.
Log Book:
The student will maintain log book of all the procedures done in non-invasive
(diagnostic) lab and cath lab including emergency procedures, which will indicate the
procedure assisted as 1st and 2nd assistant and procedures conducted by self for
Curriculum DM (Cardiology)
8
following procedures: Pericardial Tap, Hemodynamic Monitoring, Echocardiography –
transthoracic & Transesophageal, TMT, Holter Monitoring, Tilt Table Test, Coronary
Angiography, PTCA, Balloon Valvuloplasty, Temporary Pacemaker, Permanent
Pacemaker, AICD, Biventricular Pacemaker, IABP Insertion.
6. Research Project:
Every candidate shall carry out work on an assigned research project under the
guidance of a recognized postgraduate teacher, the project shall be written and
submitted in the from of a Project.
Every candidate shall submit project plan to university within time frame set by
university
Thesis shall be submitted to the University within 9 months of joining the course.
The student will (i) identify a relevant research problem, (ii) conduct a critical review
of literature, (iii) formulate a hypothesis, (iv) determine the most suitable study
design, (v) state the objectives of the study, (vi) prepare a study protocol, (viii)
undertake a study according to the protocol, (viii) analyze and interpret research
data, and draw conclusion, (ix) write a research paper.
7. Assessment
All the residents are assessed daily for their academic activities and also periodically.
7.1. General Principles:
The assessment should be valid, objective, and reliable.
It should cover cognitive, psychomotor and affective domains.
Formative and summative (final) assessment is to be conducted in theory as well as
practicals /clinical. In addition, project should be assessed separately.
7.2. Formative Assessment
The formative assessment is continuous as well as end of term.
The former is based on the feedback from the consultants concerned.
Formative assessment will provide feedback to the candidate about his/her
performance and help to improve in the areas they lack.
Record of internal assessment should be presented to the board of examiners for
consideration at the time of final examination.
7.3. Internal Assessment
The performance of the resident during the training period should be monitored
throughout the course and duly recorded in the log books as evidence of the ability and
daily work of the student. Marks should be allotted out of 100 as follows.
Sr. No. Items Marks
1. Personal Attributes 20
2. Clinical Work 20
3. Academic activities 20
Curriculum DM (Cardiology)
9
4. End of term theory examination 20
5. End of term practical examination 20
7.3.1 Personal attributes:
Behavior and Emotional Stability: Dependable, disciplined, dedicated, stable in
emergency situations, shows positive approach.
Motivation and Initiative: Takes on responsibility, innovative, enterprising, does
not shirk duties or leave any work pending.
Honesty and Integrity: Truthful, admits mistakes, does not cook up information,
has ethical conduct, exhibits good moral values, loyal to the institution.
Interpersonal Skills and Leadership Quality: Has compassionate attitude
towards patients and attendants, gets on well with colleagues and paramedical
staff, is respectful to seniors, has good communication skills.
7.3.2 Clinical Work:
Availability: Punctual, available continuously on duty, responds promptly on calls
and takes proper permission for leave.
Diligence: Dedicated, hardworking, does not shirk duties, leaves no work pending,
does not sit idle, competent in clinical case work up and management.
Academic ability: Intelligent, shows sound knowledge and skills, participates
adequately in academic activities, and performs well in oral presentation and
departmental tests.
Clinical Performance: Proficient in clinical presentations and case discussion
during rounds and OPD work up. Preparing Documents of the case
history/examination and progress notes in the file (daily notes, round discussion,
investigations and management) Skill of performing bed side procedures and
handling emergencies.
7.3.3 Academic Activity: Performance during presentation at Journal club/ Seminar/
Case discussion/Stat meeting and other academic sessions. Proficiency in skills as
mentioned in job responsibilities.
7.3.4 End of term theory examination conducted at end of 1st, 2nd year and after 2
years 9 months
7.3.5 End of term practical/oral examinations after 2 years 9 months.
Curriculum DM (Cardiology)
10
Marks for personal attributes and clinical work should be given annually by all
the consultants under whom the resident was posted during the year. Average of the
three years should be put as the final marks out of 20.
Marks for academic activity should be given by the all consultants who have
attended the session presented by the resident.
The Internal assessment should be presented to the Board of examiners for due
consideration at the time of Final Examinations.
7.4. Summative Assessment
Ratio of marks in theory and practical will be equal.
The pass percentage will be 50%.
Candidate will have to pass theory and practical examinations separately.
A. Theory examination
Paper Title Marks
Paper - I Basic sciences as related to Cardiology 100
Paper - II Clinical/ Cardiology 100
Paper - III Investigative Cardiology 100
Paper - IV Recent advances in Cardiology 100
Total 400
B. Practical & Viva-Voce Examinations
Sr. No. Description Marks
1. Long case (Valvular heart disease)(1) 100
2. Short cases (Including one case of congenital 150
heart disease)(2) 75 marks each
3. Procedures 50
(The candidate will be expected to perform
echocardiography during the examination)
4. Viva-Voce 100
Total 400
The practical examination would include a final viva-voce on fundamentals and
principles of cardiovascular diseases, their management and recent advances in field of
cardiology. It would also include viva-voce on spotters like:
- Electrocardiogram (Coronary artery disease, arrhythmias, Congenital heart disease,
dyselectrolytemia etc.)
- Cardiac catheterization and hemodynamic data
Curriculum DM (Cardiology)
11
- Arterial blood gas
- Chest x-ray (Congenital heart disease, valvular heart disease, cardiomyopathy,
pericardial involvement etc.)
- Reporting coronary angiogram.
8. Job Responsibilities
Outdoor Patient (OPD) Responsibilities
• The working of the residents in the OPD should be fully supervised.
• They should evaluate each patient and write the observations on the OPD card
with date and signature.
• Investigations should be ordered as and when necessary using prescribed forms.
• Residents should discuss all the cases with the consultant and formulate a
management plan.
• Patient requiring admission according to resident’s assessment should be shown
to the consultant on duty.
• Patient requiring immediate medical attention should be sent to the casualty
services with details of the clinical problem clearly written on the card.
• Patient should be clearly explained as to the nature of the illness, the treatment
advice and the investigations to be done.
• Resident should specify the date and time when the patient has to return for
follow up.
In-Patient Responsibilities
Each resident should be responsible and accountable for all the patients
admitted under his care. The following are the general guidelines for the functioning of
the residents in the ward:
• Detailed work up of the case and case sheet maintenance:
• He/She should record a proper history and document the various symptoms.
Perform a proper patient examination using standard methodology. He should
develop skills to ensure patient comfort/consent for examination. Based on the
above evaluation he/she should be able to formulate a differential diagnosis and
prepare a management plan. Should develop skills for recording of medical
notes, investigations and be able to properly document the consultant round
notes.
• To organize his/her investigations and ensure collection of reports.
• Bedside procedures for therapeutic or diagnostic purpose.
• Presentation of a precise and comprehensive overview of the patient in clinical
rounds to facilitate discussion with senior residents and consultants.
• To evaluate the patient twice daily (and more frequently if necessary) and
maintain a progress report in the case file.
• To establish rapport with the patient for communication regarding the nature
of illness and further plan management.
Curriculum DM (Cardiology)
12
• To write instructions about patient’s treatment clearly in the instruction book
along with time, date and the bed number with legible signature of the
resident.
• All treatment alterations should be done by the residents with the advice of the
concerned consultants and senior residents of the unit.
Admission day
Following guidelines should be observed by the resident during admission day.
• Resident should work up the patient in detail and be ready with the preliminary
necessary investigations reports for the evening discussion with the consultant on
duty.
• After the evening round the resident should make changes in the treatment and
plan out the investigations for the next day in advance.
Doctor on Duty
• Duty days for each Resident should be allotted according to the duty roster.
• The resident on duty for the day should know about all sick patients in the wards
and relevant problems of all other patients, so that he could face an emergency
situation effectively.
• In the morning, detailed over (written and verbal) should be given to the next
resident on duty. This practice should be rigidly observed.
• If a patient is critically ill, discussion about management should be done with the
consultant at any time.
• The doctor on duty should be available in the ward through out the duty hours.
Care of Sick Patients
• Care of sick patients in the ward should have precedence over all other routine
work for the doctor on duty.
• Patients in critical condition should be meticulously monitored and records
maintained.
• If patient merits ICU care then it must be discussed with the senior residents and
consultants for transfer to ICU.
Resuscitation skills
At the time of joining the residency programme, the resuscitation skills should be
demonstrated to the residents and practical training provided at various work stations.
• Residents should be fully competent in providing basic and advanced cardiac life
support.
• They should be fully aware of all advanced cardiac support algorithms and be
aware of the use of common resuscitative drugs and equipment like defibrillators
and external cardiac pacemakers.
• The resident should be able to lead a cardiac arrest management team.
Discharge of the Patient
Curriculum DM (Cardiology)
13
• Patient should be informed about his/her discharge one day in advance and
discharge cards should be prepared 1 day prior to the planned discharge.
• The discharge card should include the salient points in history and examination,
complete diagnosis, important management decisions, hospital course and
procedures done during hospital stay and the final advice to the patient.
• Consultants and DM Residents should check the particulars of the discharge card
and counter sign it.
• Patient should be briefed regarding the date, time and location of OPD for the
follow up visit.
In Case of Death
• In case it is anticipated that a particular patient is in a serious condition, relatives
should be informed about the critical condition of the patient beforehand.
• Residents should be expected to develop appropriate skills for breaking bad news
and bereavements.
• Follow up death summary should be written in the file and face sheet notes must
be filled up and the sister in charge should be requested to send the body to the
mortuary with respect and dignity from where the patient’s relatives can be
handed over the body.
• In case of a medico legal case, death certificate has to be prepared in triplicate
and the body handed over to the mortuary and the local police authorities should
be informed.
• Autopsy should be attempted for all patients who have died in the hospital
especially if the patient died of an undiagnosed illness.
Bedside Procedures
The following guidelines should be observed strictly:
• Be aware of the indications and contraindications for the procedure and record it
in the case sheet. Rule out contraindications like low platelet count, prolonged
prothrombin time, etc.
• Plan the procedure during routine working hours, unless it is an emergency.
Explain the procedure with its complications to the patient and his/her relative and
obtain written informed consent on a proper form. Perform the procedure under
strict aseptic precautions using standard techniques. Emergency tray should be
ready during the procedure.
• Make a brief note on the case sheet with the date, time, nature of the procedure
and immediate complications, if any.
• Monitor the patient and watch for complications(s).
Medico-Legal Responsibilities of the Residents
• All the residents are given education regarding medico-legal responsibilities at the
time of admission in a short workshop.
• They must be aware of the formalities and steps involved in making the correct
death certificates, mortuary slips, medico-legal entries, requisition for autopsy etc.
Curriculum DM (Cardiology)
14
• They should be fully aware of the ethical angle of their responsibilities and should
learn how to take legally valid consent for different hospital procedures &
therapies.
• They should ensure confidentiality at every stage.
9. Suggested Books & Journals
9.1 Books
Braunwald’s Heart Disease
Hurst’s The Heart
Grossman's Cardiac Catheterization, Angiography, and
Intervention
Stress Testing: Principles and Practice by Myrvin H.
Ellestad
Drugs for the Heart by Lionel H. Opie
The Cardiac Catheterization Handbook by Morton L. Kern
Hemodynamic Rounds by Morton J. Ker
Moss and Adams' Heart Disease in Infants, Children, and Adolescents
Pediatric Cardiology for Practitioners (4th Edition) by Myung K. Park
Feigenbaum's Echocardiography
Shamroth’s An Introduction to Electrocardiography
Valvular Heart Disease by Alpert & Dalen
9.2 Journals
New England Journal of Medicine
The Lancet
Journal of American College of Cardiology
Circulation
Heart
Indian Heart Journal
Hypertension
American Journal of Cardiology
Journal of Interventional Cardiology
10. Model Question Papers
Curriculum DM (Cardiology)
15
MODEL TEST PAPERS
DM (Cardiology)
Paper -I
Basic sciences as related to Cardiology
Maximum Marks : 100 Time : 3 Hours
• Attempt ALL questions.
• Answer each question and its parts in SEQUENTIAL ORDER.
• ALL questions carry equal marks.
• Illustrate your answer with SUITABLE DIAGRAMS.
1. Laplace Principle :- Definition and clinical implication in natural history of chronic
severe mitral regurgitation.
2. Describe the schematic of the evolution of atherosclerotic plaque and enumerate the
features of vulnerable atherosclerotic plaque.
3. Describe fetal circulation and changes at birth.
4. Mention the 3 natriuretic peptides : Discuss the role of BNP in patients with heart
failure.
5. Treppe (Bowditch effect) – Definition and relevance in normal and disease states.
6. Left atrial appendage : Anatomical features, pathophysiology & therapeutic
importance.
7. Write a short note on mechanism of action of Ezetimibe and fibrates.
8. Write a short note on endothelin its mode of action and the clinical implications.
9. Described the phases of action potential and its implication in arrhythmias
[Link] the different types of reperfusion injury with their etiopathogenesis and
enumerate common reperfusion arrhythmias.
Curriculum DM (Cardiology)
16
MODEL TEST PAPERS
DM (Cardiology)
Paper –II
Clinical Cardiology
Maximum Marks : 100 Time : 3 Hours
• Attempt ALL questions.
• Answer each question and its parts in SEQUENTIAL ORDER.
• ALL questions carry equal marks.
• Illustrate your answer with SUITABLE DIAGRAMS.
1. Discuss in detail the management of post operative TOF patient aged 18 years.
2. Write a short note on classification and pathogenesis of stent thrombosis.
3. Differentiate in tabular form the haemodynamics in cardiac tamponade and
constrictive percarditis.
4. Write a short note on etiopathogenesis and management of carcinoid heart disease.
5. Enumerate the features associated with high risk of sudden cardiac death in a
patient of hypertrophic obstructive cardiomyopathy (HOCM) and describe
Brockenbrough – Braunwald phenomenon in HOCM.
6. Describe the arterial pressure tracings in 4 phases of valsalva manouver in a normal
adult and a case of heart failure.
7. Write a short note on catecholaminergic polymorphic ventricular tachycardia (CPVT)
– the clinical features; electrocardiogram, genetic basis and mention the treatment
options.
8. Write a short note on HAPE (High altitude pulmonary edema) –definition,
pathophysiology, mechanism and treatment.
9. Describe the mechanism & clinical presentation of neurocardiogenic syncope and
enumerate the pharmacological agents used for its treatment.
[Link] in detail microvascular obstruction and no reflow phenomenon after
percutaneous coronary interventions.
Curriculum DM (Cardiology)
17
MODEL TEST PAPERS
DM (Cardiology)
Paper –III
Investigative Cardiology
Maximum Marks : 100 Time : 3 Hours
• Attempt ALL questions.
• Answer each question and its parts in SEQUENTIAL ORDER.
• ALL questions carry equal marks.
• Illustrate your answer with SUITABLE DIAGRAMS.
Write a short note on the following :-
1. Sinus node recovery time and its clinical implication.
2. Myocardial perfusion imaging in cardiology.
3. Fractional flow reserve as a determinant of myocardial revascularization.
4. Intravascular imaging for vulnerable plaque.
5. BNP & its role in evaluation of heart failure.
6. Head up till test (HUTT).
7. Carotid intimal medial thickness.
8. Lipoprotein a.
9. Endo myocardial biopsy.
[Link] findings and cardiac catheterization in evaluation of constrictive
pericarditis, cardiac tamponade and restrictive cardiomyopathy.
Curriculum DM (Cardiology)
18
MODEL TEST PAPERS
DM (Cardiology)
Paper –IV
Recent advances in Cardiology
Maximum Marks : 100 Time : 3 Hours
• Attempt ALL questions.
• Answer each question and its parts in SEQUENTIAL ORDER.
• ALL questions carry equal marks.
• Illustrate your answer with SUITABLE DIAGRAMS.
Write a short note on the following :-
1. Management of left main disease - current status and discuss results of SYNTAX
trial.
2. Multisite pacing.
3. Cardiocerebral resuscitation.
4. Percutaneous aortic valve implantation.
5. Mechanism of action and role of Dronedarone in management of atrial fibrillation.
6. CARTO Mapping.
7. Percutaneous implantable cardioverter defibrillation.
8. Status of prasugrel in present day era.
9. Newer therapy for pulmonary hypertension.
[Link] in AF ablation.
Curriculum DM (Cardiology)
