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EECC.pdf
- 3. Exam format • Exam date: Held once/ year, next one (18th June 2024) • Exam registration through your national society • Exam fees (400 Euro) • 120 MCQ questions over 3 hours • Delivered using online proctoring platform (ProctorU®).
- 6. 1- ESC Guidelines https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines Focus on: > Start with PowerPoint slides > Diagnostic and management algorithms > Guidelines full text reading if you have time
- 7. 2-EECC free preparatory course Focus on: > short ESC congress lectures (10-20 minutes) > ESC guidelines presentation > Miscellaneous& imaging lectures
- 9. 3-BJCA course Very useful Complimentary free access upon exam registration
- 10. Other Complimentary ESC textbook free access upon exam registration (Optional) IF you want to go more in depth in selected topics
- 11. Other (Optional) IF you want to go more in depth in selected topics
- 12. MCQ practicing
- 13. 1- Study PRN question bank
- 14. 1- Study PRN question bank sample
- 15. 2-MCQ revision videos Complimentary free access upon exam registration
- 16. 3-Mock exam Available online one month ahead of exam date
- 17. Direct Q 40% Modrete difficulty 20% Difficult 20% very tricky 20% QUESTIONS LEVEL ESC guidelines slides EECC & BJCA preparatory course videos MCQ practicing (Study PRN, BJCA) Guidelines full text ECG & imaging practice
- 18. Heart failure 10% Valvular& endocarditis 10% CCS 10% ACS 10% VT&SCD 10% SVT& AF 5% Pacing& syncope 5% GUCH& pregnancy 5% PHTN& embolism 5% Pericardial& HTN 5% HCM& sports 5% Aorta& peripheral 5% Dyslipid&DM&Prevention 5% Perioperative 5% Cardio-oncology 5% TOPICS %
- 19. What to focus on in guidelines? “According to my exam questions”
- 20. Heart failure guidelines • HF diagnosis (Most specific, sensitive signs?), algorithm (BNP before ECHO) • BNP DD (What ↑ or ↓ ) • HF TTT sequencing in different scenarios , indications for iron TTT, CRT,ICD • Acute heart failure work up and TTT according to hemodynamics • Hyperkalemia in HF • HF recovered EF management • HFpEF diagnosis , role of exercise and TTT (Cutoff point ARNI EF < 57%) • Heart transplantation/ LVAD indications/ contraindication and complications • Temporary mechanical support choice (IABP vs ECMO) • Myocarditis diagnosis (CMR imaging), management • Amyloidosis types &diagnosis (GLS, CMR), management
- 21. Valvular guidelines • Timing of surgery in asymptomatic patients (AS, MS, AR, MR, TR) • Role of exercise in asymptomatic AS and MS • Low-gradient AS different scenarios, role of dobutamine/Ca score and management • TAVR vs. SAVR • Mitral clip indications • Multivalvular heart disease (Assessment of severity, limitations of different parameters) • Prosthetic valve choice, INR targets, imaging (TTE,TEE,3D) • Prosthetic dysfunction , and thrombosis management • Tricuspid valve intervention indications • Calcific mitral stenosis assessment • Rheumatic fever diagnosis , prophylaxis and management
- 22. Endocarditis guidelines • Which patient need prophylaxis • Diagnostic criteria (Imaging TTE,TEE) and empirical regimens • Timing and indications of surgery • Culture negative endocarditis • Prognostic factors • Implantable devices endocarditis • Special scenarios (CVS, cerebral hge) • Mimics of endocarditis ( Marantic , libman sac imaging)
- 23. Aorta & Peripheral guidelines • Timing of intervention (TAA, AAA) in normal, bicuspid and marfan in details ( > or ≥ is tricky ) • Aortic dissection diagnosis • Rupture coronary sinus of Valsalva presentation • Vasculitis (Takayasu) • Antiplatelet in TIA, PAD • Indications for carotid intervention , surgery vs. stent
- 24. CCS guidelines • Pretest probability and risk stratification modality choice (CT, MPI, Dobutamine echo, Invasive?) • Image interpretation (Dobutamine ECHO, MPI, CMR), MPI artifacts • Antianginal 1st line, 2nd line, in special scenario ( Low BP, HR, spasm, bridge, ….) • Indication for angiography and revascularization (PCI vs, CABG) • Lead misplacement ECG
- 25. ACS guidelines • STEMI equivilant diagnosis (ECGs e.g. wellen , LBBB sgarbossa , Dewinter, LM ECG,…..) • Antiplatelet management in different scenario (High bleeding risk, perioperative, duration, OAC patints) • MI complications ( VSR, rupture, arrhythmia ) management • Time frames for choice of TTT strategy ( PPCI vs pharmacoinvasive) • MINOCA workup (CMR imaging), Mimics (e.g. Taktsubo diagnosis) • SCAD imaging (Angio) and management • Timing and indications of ICD
- 26. VT&SCD guidelines • ICD indications in different scenarios • Long QT diagnosis (ECG) and management • Catecholenergic polymorphic VT diagnosis (ECG) and management • Fascicular VT/ RVOT diagnosis (ECG) and management • PVC management , indication for ablation • Brugada $ diagnosis (ECG), sports?, and management • ERP syndrome • ARVC diagnosis (ECG and CMR), sports?, and management • Sarcoidosis diagnosis (CMR, PET” Activity) and ICD indications • Causes and work up for SCD and family screening • VT storm • ICD appropriate vs. inappropriate shock (Atrial arrhythmia)
- 27. SVT & AF guidelines • 1st option in TTT of….. (Read guidelines algorithms carefully) • POTS diagnosis and management • WPW risk stratification and management • Preexcited AF diagnosis (ECG) and management • Intracardiac tracing of SVT! • Proper choice of rhythm control drug in different scenarios • Indications for AF ablation and complications of PVI • AF in HF and CRT patients • Anticoagulation indications (Scores), bleeding management, antidotes
- 28. Pacing& syncope guidelines • Heart block ECGs (Mobitz I, II, complete), indications for pacing • Syncope in elderly vs. falls , 1st investigation • Bi-fascicular block & syncope management • Indications of pacing in reflex syncope • Pacing options in heart failure with AV block • MRI safety in cardiac electronic devices • Pacemaker trouble shooting (ECG), complications (short, long term) • Driving scenarios
- 29. PHTN &Pulmonary embolism guidelines • Indications of lytic therapy and percutaneous intervention • Choice of anticoagulation and regimens • Indications of IVC filter • Screening algorithm for CTEPH, risk factors • PHTN types and defintions (Pre vs. post capillary ) , hemodynamic tracing • Risk stratification strata and management of PH (Drug sequencing)
- 30. GUCH& Pregnancy guidelines • Indications of VSD, ASD, PDA closure , imaging diagnosis • Indications of intervention in pulmonary stenosis • TOF complications , management of pulmonary regurge (Indications) • Coronary anomalies imaging (MSCT) , role of exercice stress & management • Fontan and arrhythmia • Eisenmenger $ • Anticoagulation during pregnancy • Contraindication of pregnancy in cardiac patients (WHO classes), mode of delivery • IE prophylaxis • D.D dilated RV (TEE imaging) • Management of arrhythmia (Drug safety/DC) &VHD and HTN in pregnancy
- 31. Perioperative guidelines • Perioperative drug management (SGLT2i, ACE-I, OAC, antiplatelets,…) • OAC when to bridge and how • NOAC management • Indications for pre-op stress imaging • Indications for pre-op revascularization • Asymptomatic valvular heart disease management
- 32. Cardio-oncology guidelines • Cardiotoxicity prevention, surveillance , When to hold TTT ? • Long term FU plan • ICI & T-CART myocarditis • Arrhythmia side effects od ibrutinib (AF) • 5FU coronary spasm • Radiotherapy • Cardiac tumors • Role of PET, CMR in cardiac masses
- 33. Dyslipidemia& DM& Prevention guidelines • LDL targets in different subsets • Non-statin therapy indications • Statin intolerance management • Statin in heart failure and hemodialysis patients • Familial hypercholesterolemia diagnosis, genetic screening • Lipoprotein a • Risk stratification SCORE, when to calculate • Role of ACE-I, aspirin , SGLT2i , Colchicine for 1ry prevention
- 34. Sports& HCM guidelines • HCM risk assessment • HCM imaging (ECHO, CMR) • ICD indications • Sports in HCM • ECG changes in athelete, when to further investigate • Exercise return post pericarditis and myocarditis in atheletes • CMR LGE in athelete and management • Exercise prescription in different valvular , HF, IHD scenarios
- 35. Pericardial & HTN guidelines • Pericarditis diagnosis (CMR imaging), TTT regimens and duration • Chronic, refractory pericarditis • Pericardial effusion management and timing of FU • Constrictive pericarditis diagnosis (CMR, hemodynamic tracing), management • Cardiac tamponade diagnosis (ECHO, hemodynamic tracing) • HTN definition, stages, when to treat, combination therapy • Resistant hypertension workup and management • Secondary hypertension causes and workup • HTN emergency workup and management
- 36. Final tips • Try to make your own summary for important guidelines recommendations and tips from EECC & BJCA preparatory courses • Try to make MCQ key points as bullets in your notebook • At least 50% of questions contains imaging (TTE,TEE,CMR,CT,PET,MPI), or ECG which may contains a clue for MCQ, so try to focus on EECC & BJCA imaging and ECG section
- 37. Best of luck for every one… Aswan, Egypt…