Exam Content Outline

The 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, Cardiovascular Diseases Pathophysiology is 8% of the exam, whereas Intervention is 16%.

The complete outline for the Registered Cardiovascular Invasive Specialist Examination appears below.

A. Cardiovascular Anatomy and Physiology (5%)
I. Innervation         A. Conduction system         B. Sympathetic         C. Parasympathetic    II. Coronary anatomy    III. Physiology         A. Pressure and pulse waveforms         B. Hemodynamic parameters         C. Frank-Starling principle         D. Contractility         E. Preload and afterload         F. Electrophysiology — action potential         G. Normal fetal circulation
B. Cardiovascular Diseases Pathophysiology (8%)
I. Pathology and treatment         A. VaIvular heart disease         B. Myocardial and pericardial disease         C. Artificial valves and surgery         D. Coronary artery disease — atherosclerosis         E. Heart failure and shock         F. Myocardial infarction         G. Hereditary disease              1. Pulmonary              2. Arterial              3. Stroke         H. Systemic and pulmonary hypertension         I. Congenital heart disease         J. Aortic diseases         K. Tumors         L. Aneurysms         M. Cerebrovascular accident         N. Ventricular thrombus         O. Cardiac tamponade    II. Acid base disturbance         A. Respiratory acidosis         B. Respiratory alkalosis         C. Metabolic acidosis         D. Metabolic alkalosis
C. Diagnostic Techniques (20%)
I. Catheterization techniques         A. Terminology         B. Protocol         C. Contraindications         D. Preparation and pre-medication         E. Complications         F. Arterial lines         G. Cutdown — Sones         H. Percutaneous — Seldinger         I. Position of catheters in the heart         J. Right heart catheterization         K. Left heart catheterization         L. Grafts              1. Coronary              2. Internal mammary              3. Venous         M. Electrophysiology         N. Pediatric         O. Hemostasis — closing         P. Exercise         Q. Endomyocardial biopsy         R. Provocative maneuvers    II. Angiography         A. Imaging systems              1. Radiation production              2. X-ray beam characteristics              3. Screen-film characteristics              4. Film processing              5. Imaging system performance         B. Digital imaging systems         C. Image production and evaluation         D. Selection of technical factors              1. Density              2. Contrast              3. Recorded detail              4. Distortion              5. Film and screen selection              6. Automatic exposure controls/technique         E. Complications         F. Contrast media         G. Injection techniques              1. Patient positioning              2. Angiographic angulations              3. Injector set-up/programming         H. Angiographic procedures              1. Left ventriculography              2. Coronary arteriography              3. Aortography              4. Peripheral arteriography              5. Pulmonary angiography    III. Electrocardiography         A. Arrhythmias         B. Ischemia, infarction patterns         C. Blocks         D. Measurements, waveforms and calculations         E. Artifacts, techniques         F. Hypertrophy         G. Pacemakers
D. Intervention (16%)
I. Techniques and Devices         A. AICD         B. Intra-aortic counter pulsation         C. Cardiopulmonary support circulation         D. Intravascular ultrasound         E. Doppler flow wire         F. Pacemakers              1. Temporary                   a. Transvenous                   b. Transcutaneous              2. Permanent                   a. Indications                   b. Implantation    II. Defibrillation and cardioversion    III. Percutaneous transluminal angioplasty    IV. Thrombolytic therapy    V. Surgical correction         A. Congenital heart disease         B. Coronary bypass         C. VaIvular repair    VI. Valvuloplasty    VII. Pericardiocentesis    VIII. Stents    IX. Atherectomy    X. Laser
E. Hemodynamic Data (15%)
I. Cardiac output determinations         A. Fick         B. Angiographic         C. Thermaldilution         D. Comparison of methods         E. Shunts         F. Regurgitant fraction         G. Ejection fraction    II. Calculations         A. Oxygen capacity         B. AV02 difference         C. Cardiac output         D. Systemic and pulmonary resistance         E. Systemic and pulmonary blood flow         F. Shunts         G. Regurgitant fraction         H. Ejection fraction         I. Valve area         J. Normal calculated values    III. Pressures         A. Normal and abnormal — waveforms, pressure levels, etc.         B. Time pressure relationships         C. Pullback identification         D. VaIvular gradients         E. Insufficient valves         F. Constrictive/restrictive pressures         G. Heart failure pressures         H. Provocative maneuvers         I. Pressure analysis
F. Pharmacology (7%)
I. Drug classifications         A. Adrenergic         B. Cholinergic         C. Vasopressors         D. Vasodilators         E. Diuretics         F. Antihypertensives         G. Local anesthetics         H. Anticoagulants         I. Antiplatelet         J. Thrombolytics         K. Nitrates         L. Antiarrythmics         M. Calcium channel blockers         N. Contrast agents         O. Cardiac glycosides         P. Controlled substances         Q. Oxygen         R. Beta blockers    II. Types and administration routes         A. Indications and contraindications         B. Preparation and dosage         C. Complications         D. Actions    III. Contrast administration         A. Types and properties of contrast agents         B. Indications and contraindications    IV. Therapy         A. Indications and contraindications         B. Venipuncture         C. Solution preparation         D. Flow rate         E. Complications
G. Equipment and Instrumentation (11%)
I. Radiographic equipment         A. Cine cameras         B. Operating console         C. X-ray tube         D. X-ray oxenerator, rectifier, and transformer         E. Automatic exposure controls         F. Beam restriction devices         G. Basic principles of x-ray production         H. Recognition of malfunctions         I. Fluoroscopic timer         J. Electrical hazards    II. Film processing         A. Film storage         B. Screens and cassettes         C. Radiographic identification         D. Film processor    III. Automatic pressure injectors         A. Parts         B. Function         C. Operation    IV. Catheters, guidewires, needles         A. Types         B. Construction         C. Use    V. Implantable devices         A. Caval filters         B. Central venous catheters         C. Embolic materials         D. Stents         E. Permanent pacemakers and defibrillators    VI. Cardiac output equipment    VII. Pressure recorders    VIII. Temporary pacemakers    IX. External defibrillators    X. Transducers    XI. Quality control         A. Concepts and principles of quality control              1. Basis of QC              2. Problem solving strategies         B. Collection & analysis of QC data              1. Development of indicators              2. Data collection methods              3. Data analysis              4. Assessment of outcomes              5. Required QC tests              6. Frequency of QC tests              7. Suggested performance criteria for QC tests         C. Evaluation of radiographic images              1. Criteria for diagnostic quality              2. Improving radiographic quality              3. Image characteristics              4. Image production              5. Image display         D. Film processors         E. Test objects              1. Sensitometer              2. Densitometer              3. Light meter         F. Transducers              1. Balance              2. Preparation         G. Lab equipment              1. Oximeter              2. ACT
H. Patient Care and Patient Assessment (18%)
I. Evaluation and assessment         A. Signs and symptoms of heart disease              1. Arterial and venous pulses              2. Auscultation and murmurs         B. Central nervous system assessment    II. Documentation and catheterization protocols    III. Arterial and venous line management    IV. Hemostasis    V. Legal and professional responsibilities         A. Patient identification         B. Verification of requested examination         C. Legal and medical ethics    VI. Patient education, safety and comfort         A. Communication with patients         B. Assessment of patient condition         C. Proper body mechanics for patient transfer         D. Patient privacy         E. Prevention and control of infection              1. Transmission of infection              2. Universal precautions              3. Disinfection, asepsis, and sterile technique              4. Handling of biohazardous materials              5. Type of isolation    VII. Emergency procedures         A. Patient monitoring         B. Contrast reactions and complications         C. Protocol, treatment and medications         D. Cardiopulmonary resuscitation (CPR)         E. Advanced cardiac life support (ACLS)              1. Universal algorithm              2. Defibrillation and cardioversion              3. Airway management              4. Pharmacology    VIII. Patient assessment implications, normal and abnormal values         A. Vital signs         B. Access assessment (venous and arterial)         C. Normal lab values         D. Lab results              1. Electrolytes              2. Blood gases              3. Blood chemistry         E. Physiologic monitoring         F. Maintenance of accessory medical devices    IX. Radiation protection         A. Patient protection         B. Biological effects of radiation         C. Minimizing patient exposure         D. Personnel protection              1. Sources of radiation exposure              2. Basic methods of protection              3. Radiation exposure and monitoring                   a. Units of measurement                   b. Dosimeters (types, proper use)                   c. NCRP recommendations for personnel monitoring

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