Exam Content Outline

Cardiovascular Credentialing International publishes its exam outlines and other important information on its website (www.cci-online.org). Visit the site for complete information about applying for and taking the registry examinations. The outline for each exam indicates the approximate percentage of the exam that a particular topic represents. This information is important because it indicates the relative importance of each topic and allows you to study more effectively. For example, Two Dimensional and M-mode Echocardiography is 20% of the exam, whereas the Patient Management/Clinical Medicine is 11%.

The complete outline for the Registered Cardiac Sonographer Examination appears below.

A. Patient management/clinical medicine (11%)
I. Patient Management         A. Basic patient care         B. Transportation and proper body mechanics         C. Emergency care         D. Medical ethics    II. Clinical medicine         A. Physical Assessment              1. Inspection and palpation of arterial and venous pulses              2. Auscultation              3. Blood pressure         B. Basic pharmacology              1. Antihypertensives              2. Antiarrythmics              3. Anticoagulants              4. Calcium channel blockers              5. Chronotropic agents              6. Inotropic agents              7. Nitrates              8. Oxygen              9. Sedatives              10. Vasopressors              11. Vasodilators              12. Diuretics              13. ACE inhibitors              14. Contrast agents         C. Defibrillation/emergency measures         D. Sterile Technique
B. Ultrasound physics and instrumentation (15%)
I. Physical properties of ultrasound         A. Definition         B. Terms              1. Cycle              2. Wavelength              3. Velocity              4. Frequency              5. Harmonics         C. Velocity of sound in human tissue         D. Propagation speed in different media    II. Acoustical properties of tissue         A. Impedance         B. Reflection         C. Refraction         D. Specular echoes         E. Scattered echoes         F. Resolution         G. Attenuation    III. Principles of Doppler         A. Doppler effect         B. Doppler equation    IV. Doppler instrumentation         A. Continuous wave              1. Advantages — high velocity detection              2. Disadvantages — range definition         B. Pulsed doppler              1. Limitations              2. Aliasing                   a. Nyquist effect                   b. Effect on flow and velocity                   c. PRF         C. High pulsed repetition frequency pulsed Doppler              1. Effect on Nyquist effect    V. Doppler display    VI. Doppler controls    VII. Color flow mapping         A. Sampling methods         B. Artifacts         C. Limitations    VIII. Transducers and sound beams         A. Design         B. Piezoelectric effect         C. Sound beam formation              1. Near field              2. Fairfield              3. Focal zone         D. Beam focusing         E. Resolution              1. Axial              2. Lateral         F. Transducer Types              1. Focused single crystal              2. Phased array              3. Annular array              4. Mechanical    IX. 2-D, Doppler and color flow         A. Characteristics         B. Processing and displays         C. Instrumentation         D. Imaging, Doppler and color flow artifacts         E. Storage, displays and recording devices         F. Computer manipulation of data    X. Quality control, troubleshooting, and preventative maintenance    XI. Biologic Effects and Safety Considerations         A. Mechanisms of bioeffects         B. Epidemiology         C. AIUM statements         D. Electrical and mechanical hazards
C. Pathophysiology of Cardiovascular Diseases/ Therapeutic      Measures Identify the etiology, symptoms, pathophysiology,      hemodynamic effect and treatment (20%)
I. Congenital heart disease         A. Embryology         B. Abnormalities of the left & right aria and systemic veins         C. Anomalies of the right and left ventricular inflow         D. Right and left ventricular outflow tract obstruction         E. Congenital lesions leading to intracardiac shunts         F. Abnormalities of the great vessels         G. VaIvular abnormalities         H. Surgical/palliative procedures    II. Valvular heart disease         A. Mitral valve disease         B. Aortic valve disease         C. Tricuspid valve disease         D. Pulmonary valve disease    III. Ischemic Heart Disease         A. Coronary Artery Disease         B. Left ventricular obstruction         C. Wall motion abnormality         D. Associated thrombi         E. Aneurysm         F. Rupture of the papillary muscle, chordae, and interventricular              septum         G. Arrhythmia and conduction disturbance    IV. Inflammatory Heart Disease         A. Endocarditis         B. Myocarditis         C. Pericarditis    V. Cardiomyopathy         A. Dilated         B. Constrictive         C. Restrictive         D. Hypertrophic              1. Obstructive              2. Non-obstructive    VI. Pericardial diseases         A. Effusion         B. Constrictive         C. Tumor         D. Cardiac tamponade    VII. Cardiac masses         A. Benign         B. Malignant    VIII. Diseases of the aorta    IX. Systemic and pulmonary hypertension    X. Compensatory mechanisms    XI. Basic understanding of interventional procedures         A. Valvular repair/replacement         B. Coronary arteries         C. Catheterization/intervention
D. Two Dimensional and M-mode Echocardiography (20%)
I. Deductive echocardiography and the segmental approach of       cardiac anatomy    II. Basic and advanced techniques and imaging planes    III. Normal values and quantitative measurements/calculations    IV. Qualitative evaluation of cardiac chambers and myocardial          wall segments    V. Hemodynamic information derived from echocardiography         A. Measurements         B. Normal parameters         C. Equations    VI. Two-dimensional recognition and assessment         A. Congenital heart disease         B. VaIvular heart disease         C. Inflammatory heart disease         D. Ischemic heart disease         E. Cardiomyopathy         F. Pericardial diseases         G. Cardiac masses         H. Diseases of the aorta         I. Systemic and pulmonary hypertension         J. Prosthetic valves         K. Left ventricular function
E. Cardiac Doppler and color flow echocardiography (20%)
I. Normal and abnormal flow patterns    II. Normal values and quantitative measurements and calculations    III. Clinical applications in acquired and congenital heart disease         A. Left sided lesion         B. Right sided lesion         C. Intracardiac shunt         D. Hemodynamic assessment         E. Prosthetic valves         F. Systolic/diastolic function
F. Advanced Techniques in Echocardiography (10%)
I. Pharmacologic application    II. Ultrasound contrast studies    III. Stress echocardiography    IV. Transesophageal echocardiography    V. Harmonic imaging    VI. Physiologic maneuvers
G. Other Non-invasive Modalities (4%)
I. Electrocardiography and Holter monitoring    II. Exercise stress testing    III. Nuclear cardiology    IV. Pacemakers    V. Chest X-Ray

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