Most Frequently Tested Cardiology Topics (MRCP Part 1)

TL;DR

If you're preparing for MRCP Part 1, cardiology is one of the most heavily tested specialties. This guide summarises the most frequently tested cardiology topics (MRCP Part 1), including must-know ECG findings, valvular disease, and heart failure management. You’ll also find a sample question, pitfalls, and an 8-week study plan to help you focus your preparation efficiently.

Why This Matters

Cardiology consistently carries one of the highest weightings in MRCP Part 1, often integrated with physiology, pharmacology, and clinical medicine questions. Understanding the recurring concepts — rather than memorising guidelines — can help you answer with confidence.

Crack Medicine’s structured system for MRCP Part 1 helps you link clinical reasoning with recall through our MRCP Part 1 overview, Free MRCP MCQs, and timed mock tests that simulate real exam pressure.

10 Most Frequently Tested Cardiology Topics

No.	Topic	What to Focus On for MRCP Part 1
1	Ischaemic Heart Disease (IHD)	Diagnostic differences between STEMI and NSTEMI, troponin kinetics, and secondary prevention drugs (statins, ACE inhibitors, β-blockers).
2	Heart Failure	NYHA classes, stepwise drug ladder (ACE i → β-blocker → MRA → SGLT2i), and acute vs chronic features.
3	Valvular Heart Disease	Murmur timing and radiation (AS vs MR vs MS vs AR), key echocardiographic features, and prosthetic valve complications.
4	Arrhythmias & ECG Interpretation	AF, atrial flutter, AV block types, SVT vs VT differentiation, QT-prolonging drugs.
5	Hypertension	NICE NG136 stepwise management, secondary causes (Conn’s, phaeochromocytoma), and hypertensive crises.
6	Congenital Heart Disease	Eisenmenger’s physiology, ASD/VSD shunts, and common cyanotic lesions.
7	Cardiomyopathies	Hypertrophic cardiomyopathy diagnostic criteria, restrictive vs dilated differences, and genetic inheritance patterns.
8	Pericardial Disease	ECG changes in pericarditis, tamponade triad, and constrictive pericarditis.
9	Infective Endocarditis	Modified Duke criteria, common organisms (Staph aureus, Viridans streptococci), and antibiotic prophylaxis principles.
10	Cardiology Pharmacology	Mechanisms, contraindications, and side-effects of β-blockers, ACE inhibitors, nitrates, and calcium channel blockers.

Quick Revision Tips

1. Master ECG recognition — MRCP Part 1 questions often describe patterns rather than showing images. Learn how to identify AF, AV block, and MI territories from textual cues.

2. Understand murmurs logically: link the lesion to valve pathology, not just sound timing.

3. Always revise physiology links: preload/afterload effects appear in multiple question stems.

4. Remember drug contraindications: β-blockers in asthma, verapamil with β-blockers, etc.

5. Stay updated with NICE guidelines (e.g. NG136 for hypertension, NG106 for heart failure).

6. Use active recall and spaced repetition: cover 20–30 questions daily.

7. Practise integrated questions — many mix cardiology with renal or endocrine elements.

8. Do mock tests monthly to build pacing and resilience.

   
   

   

Mini-Case Example (Exam-Style)

Question: A 68-year-old man presents with dyspnoea and orthopnoea. His BP = 110/70 mmHg, pulse = 96 bpm (irregular), JVP raised, and bibasal crepitations are heard. ECG confirms atrial fibrillation (rate 110 bpm). Which medication improves survival?

Options: A. DigoxinB. FurosemideC. SpironolactoneD. Verapamil

Answer: ✅ C. Spironolactone Explanation: MRAs such as spironolactone reduce mortality in symptomatic HFrEF despite optimal ACE inhibitor and β-blocker therapy. Digoxin and loop diuretics relieve symptoms but offer no survival benefit.

8-Week Study Plan (Compact)

Week	Focus Area	Core Tasks
1	Ischaemic heart disease	Review ACS algorithms (NICE CG94), practise 30 MCQs.
2	Heart failure	Learn drug sequencing and echo criteria; flashcards.
3	Valvular disease	Murmurs audio review; write differential tables.
4	Arrhythmias	ECG drills, AV block classification practice.
5	Hypertension & pharmacology	Revise NICE NG136; practise drug-related questions.
6	Cardiomyopathies & pericardial disease	Compare restrictive vs dilated; review pericarditis ECGs.
7	Infective endocarditis & congenital lesions	Learn Duke criteria; attempt 150 questions.
8	Full mock + review	Attempt Start a mock test; analyse weak areas.

Common Pitfalls and Fixes

• ❌ Confusing murmurs: Mix-ups between AS and MR are frequent.→ ✅ Use timing + radiation (AS → carotids, MR → axilla).

• ❌ Ignoring ECG details: Missing rate vs rhythm clues.→ ✅ Practise timed ECG pattern questions daily.

• ❌ Over-memorising drug lists: Without mechanism understanding, you’ll falter on cross-system questions.→ ✅ Link each drug to its physiological effect.

• ❌ Neglecting updates: Outdated hypertension protocols cause wrong answers.→ ✅ Use NICE NG136 (Hypertension) and NICE NG106 (Heart Failure).

• ❌ Avoiding mocks: Real-exam stamina is often under-trained.→ ✅ Attempt full tests on the Crack Medicine mock platform.

  
  

Frequently Asked Questions (FAQs)

1. How much cardiology is in MRCP Part 1?Around 15–20 % of the paper involves direct or integrated cardiology questions, including ECGs, pharmacology, and physiology.

2. Do ECGs appear visually in the exam? Sometimes textual, occasionally schematic. Focus on key descriptive patterns such as “irregularly irregular rhythm” (AF) or “saw-tooth baseline” (atrial flutter).

3. What are the best cardiology resources?

• MRCP(UK) Official Syllabus

• Crack Medicine Free MRCP MCQs

• European Society of Cardiology Guidelines

4. Which mistakes cost the most marks? Guessing drug mechanisms and ignoring integrated physiology questions are top culprits. Practise question interpretation over rote recall.

5. How should I divide my time? Roughly 20 % study time on pure cardiology theory, 50 % on mixed MCQs, and 30 % on timed mocks for recall and exam endurance.

Ready to start?

Cardiology in MRCP Part 1 rewards clinical understanding over memorisation. Start strengthening your fundamentals through the MRCP Part 1 overview, practise with Free MRCP MCQs, and test your readiness using Start a mock test. Every hour spent on pattern recognition and active recall now will pay off on exam day.

Sources

• MRCP(UK) Part 1 Official Exam Blueprint – mrcpuk.org

• NICE NG106 – Chronic Heart Failure in Adults (2018, updated 2023)

• NICE NG136 – Hypertension in Adults (2019, updated 2023)

• European Society of Cardiology Guidelines 2023