USMLE Step 1 Cardiovascular Practice Questions
7–11% of Step 1 · 31 practice questions with a note on every option
280 questions in 14 timed 30-minute blocks, with your score in cardiovascular and every other content area.
Free cardiovascular drillA 46-year-old man who grew up in a mud-walled house in rural Bolivia comes to the physician because of progressive dyspnea on exertion and ankle swelling. He also has difficulty swallowing solid food. An ECG shows right bundle branch block and left anterior fascicular block. Echocardiography shows a dilated left ventricle with an ejection fraction of 30% and an apical aneurysm. Serologic testing confirms chronic infection with a protozoan parasite. This infection is transmitted to humans by which of the following?
Cardiovascular System on Step 1
The Cardiovascular System is 7–11% of Step 1. Expect physiology you have to reason through, such as pressure-volume loops, murmurs and cardiac output, alongside pathology of the heart and vessels and the pharmacology that treats it.
- Share of Step 1
- 7–11% of the exam, per the USMLE content outline
- On our mock exam
- 25 of 280 questions, with your score for this system in the result
- Our drill
- 10 questions from 31 cardiovascular questions, untimed, a note on every option; one free attempt, unlimited with a pass
What Step 1 cardiovascular questions test
- Cardiac physiology: the cardiac cycle, pressure-volume loops, preload, afterload and contractility
- Embryology and congenital heart disease: shunts, cyanotic lesions and their associations
- Ischemic heart disease, myocardial infarction complications by time course, and heart failure
- Valvular disease and murmurs, cardiomyopathies, pericarditis and endocarditis
- Vasculitides by vessel size, atherosclerosis and hypertension
- Pharmacology: antihypertensives, antiarrhythmics by class, lipid drugs and heart failure drugs
Sit all 280 questions in timed blocks
280 questions in 14 timed 30-minute blocks, with your score in cardiovascular and every other content area.
Free cardiovascular drillHow to study it
- Draw the pressure-volume loop and shift it for each valve lesion and each drug.
- Learn myocardial infarction complications by day after the infarct.
- Learn antiarrhythmics by class, channel and key toxicity.
Common questions
Are ECGs on Step 1?
The real exam can show ECG tracings. Our questions describe ECG findings in words, so connect each pattern to its cause: peaked T waves with hyperkalemia, delta waves with an accessory pathway.
How much physiology is in cardiology questions?
A lot. Physiology is 30–40% of Step 1 overall, and cardiac output, pressures and murmurs are some of its most tested topics.
280 questions in 14 timed 30-minute blocks, with your score in cardiovascular and every other content area.
Free cardiovascular drillThe other Step 1 systems
Sources
- USMLE: Step 1 (blocks, items, testing day, break time)
- USMLE: Step 2 CK (blocks, items, testing day, break time)
- USMLE: Test delivery software updates for Step 2 CK and Step 1 (May 2026)
- USMLE: Step 1 content outline and specifications
- USMLE: Step 2 CK content outline and specifications
- USMLE: Examination results and scoring (minimum passing scores)
- USMLE Bulletin: Scoring and score reporting (about 60% correct to pass; result timing)
- USMLE Bulletin: Eligibility (attempt limits)
- USMLE: Apply for exams (2026 and 2027 fees, FSMB registration, region fees)
- USMLE: Performance data (pass rates)
- Intealth ECFMG: Fees overview (ECFMG Certification)
Original practice questions written to the USMLE content outlines and current standard references. USMLE® is a joint program of the Federation of State Medical Boards (FSMB) and NBME. Independent practice, not affiliated with or endorsed by the FSMB, NBME or Intealth (ECFMG). Follow current guidelines in clinical practice.