ABIM ACHD study guide
ABIM ACHD · Work through your exam, one topic at a time.
The Adult Congenital Heart Disease Certification Examination is an ABIM subspecialty examination for physicians who want to demonstrate the knowledge, clinical judgment, and skills required for independent practice in the care of adults with congenital heart disease. ABIM describes its certification examinations as assessments of the knowledge, clinical judgment, and skills essential for high-quality care, and certification as evidence that a physician is ready for independent practice. The ABIM ACHD study guide has 5 sections and about 1,986 words.
01Basic Science and Epidemiology of Congenital Heart Disease
Congenital heart disease (CHD) affects roughly 8–9 per 1000 live births - taught as "about 1 in 100," rising to nearly 1–2% when bicuspid aortic valve and tiny muscular ventricular septal defects (VSDs) are included. VSD is the most common lesion at birth; bicuspid aortic valve is the most common congenital cardiac anomaly in adults.
356 words, about 2 min02Anatomy, Pathophysiology, and Natural History of Congenital Lesions
Describe every heart in sequence: atrial situs, ventricular loop, atrioventricular and ventriculoarterial connections, then associated lesions. This discipline prevents mislabeling complex anatomy (for example, congenitally corrected transposition is atrioventricular and ventriculoarterial discordance, with the morphologic right ventricle supporting the systemic circulation and progressive systemic AV valve regurgitation plus heart block).
335 words, about 2 min03Diagnostic Evaluation: Imaging, Electrocardiography, and Cardiac Catheterization
Transthoracic echocardiography is first-line for anatomy, shunts, valves, and ventricular function. Cardiac magnetic resonance is the reference standard for right ventricular volumes and function, regurgitant fractions, and flow quantification - essential in tetralogy of Fallot, conduits, and aorta surveillance.
324 words, about 2 min04Medical, Interventional, and Surgical Management
Management decisions turn on lesion, residual hemodynamics, ventricular function, and symptoms. Transcatheter options include device closure of secundum atrial septal defects, patent ductus arteriosus, and selected VSDs; balloon valvuloplasty for pulmonary and aortic stenosis; and stent or transcatheter valve implantation in right ventricular–pulmonary artery conduits.
322 words, about 2 min05Special Populations
The ACHD population is now dominated by adults, many over 60. Acquired disease - hypertension, coronary disease, diabetes, atrial fibrillation, degenerative valve disease - increasingly competes with the congenital lesion as the cause of symptoms and death.
649 words, about 3 min