ABIM ACHD study plan

Build a one-page genetics and inheritance map covering 22q11.2 deletion, Williams, Noonan, Marfan, Turner, and Alagille syndromes with their signature cardiac lesions

List the epidemiologic frequencies, sex predilections, and recurrence risks for the 12 most common congenital lesions and rank them from most to least common

Trace normal cardiogenesis from neural crest migration through septation and arch development, and identify which embryologic step fails in each of 10 representative lesions

Explain the fetal circulation and the transition at birth well enough to derive why a given lesion presents on day 1 versus week 6

Describe the segmental anatomy of 15 major lesions, stating chamber arrangement, valve anatomy, and great-vessel relationships for each

Derive the pathophysiology and hemodynamic consequences of each lesion from its anatomy rather than memorizing them

Chart the untreated natural history of each lesion, including survival milestones, timing of irreversible pulmonary vascular disease, and expected late complications

Differentiate cyanotic from acyanotic physiology and predict the direction of shunting under conditions of changing pulmonary and systemic vascular resistance

Finish the lesion matrix by adding Eisenmenger physiology, Fontan circulation, and conotruncal and univentricular lesions

Compare echocardiography, cardiac CT, and cardiac MRI on the specific anatomic and functional questions each answers best in ACHD

Map which imaging modality to choose for 10 common ACHD scenarios such as quantifying right ventricular volume, assessing a baffle, or excluding a sinus venosus defect

Interpret the radiation and contrast trade-offs that drive imaging selection in adults with repaired congenital disease

Interpret 25 ACHD electrocardiograms, identifying sinus node dysfunction, intra-atrial reentrant tachycardia, ventricular pre-excitation, and progressive conduction disease by lesion type

Perform and explain the hemodynamic calculations used in the cath lab, including shunt fraction, pulmonary and systemic vascular resistance, and valve area

Explain what each catheterization maneuver or provocative test demonstrates in a patient with a shunt, a conduit, or a Fontan circuit

Identify which lesions demand catheter-based rather than surgical reintervention and why

Sequence the staged surgical palliations for single-ventricle physiology from the Norwood procedure through the Fontan, stating the indication and the expected post-operative physiology at each stage

Compare the timing, indications, and failure modes of valve repair versus replacement in the systemic and pulmonary positions in ACHD

Select the appropriate transcatheter intervention for 10 lesion-specific scenarios, including device closure, stenting of a conduit or coarctation, and valve-in-valve procedures

Outline perioperative risk assessment for adults with congenital heart disease undergoing both cardiac and noncardiac surgery

Apply medical management to ACHD-specific problems, including pulmonary arterial hypertension, heart failure with a systemic right ventricle, arrhythmia, and endocarditis prophylaxis indications

Counsel a simulated patient with a mechanical valve, a Fontan circuit, and a repaired tetralogy of Fallot through contraception and pregnancy planning

Manage the acute presentation of each ACHD emergency, including shunt thrombosis, conduit obstruction, arrhythmia with a single ventricle, and aortic dissection in Marfan syndrome

Design a long-term surveillance schedule for 8 lesion-specific ACHD cohorts, specifying the interval and purpose of each imaging, ECG, and laboratory test

Identify the transition-of-care and loss-to-follow-up risks in ACHD and state how a structured transition program mitigates them

Integrate the multisystem complications of adult congenital heart disease, including hepatic dysfunction in Fontan circulation, erythrocytosis and hyperviscosity, aortopathy, and neurodevelopmental sequelae

Re-derive from memory the anatomy, physiology, and natural history of every lesion in the week-2 matrix

Complete 200 mixed-domain practice questions under timed conditions and categorize every error as knowledge, reasoning, or reading error

Re-teach the 20 weakest concepts aloud or in writing until each can be explained without reference material

Consolidate high-yield facts from all five domains into a final review sheet