RCCS exam guide
About the Registered Congenital Cardiac Sonographer (RCCS) exam
The CCI Registered Congenital Cardiac Sonographer examination is designed for professionals working in pediatric and adult congenital cardiac ultrasound. Use this short diagnostic to identify gaps in lesion recognition, image acquisition, ultrasound physics, adjunct imaging, and communication, then organize further study around the official examination matrix.
MedPorium is an independent education platform and is not affiliated with or endorsed by Cardiovascular Credentialing International (CCI). Exam details can change; confirm them with the official source before applying.
RCCS exam format at a glance
- Questions
- 170
- 150 scored; 20 unscored
- Time
- 3 hours (2 hours 50 minutes for questions, plus 10 minutes for the tutorial and survey)
- Delivery
- Computer-based at Pearson Professional Centers; offered year-round based on availability
Knowledge to review for the RCCS exam
These foundations support the practical tasks in the official examination matrix.
Congenital cardiovascular foundations
- Cardiovascular and general anatomy, physiology, pathophysiology, and embryology
- Congenital heart disease, pediatric-acquired heart disease, and syndromes with associated cardiac lesions
- Cardiac rhythms, interventions, complications, sequelae, and critical clinical values
Imaging, physics, and analysis
- Ultrasound physics, instrumentation, image optimization, ergonomics, and QA procedures
- ASE guidelines and basic or hemodynamic calculations, including volumes, gradients, and ejection fraction
- Adjunct modalities including 3D, contrast, ICE, stress echo, and TEE
Patient care and professional practice
- Patient assessment, contraindications, basic pharmacology, BLS, and appropriate escalation
- HIPAA, OSHA, JCAHO requirements, medical ethics, and medical terminology
- Abbreviations, acronyms, and communication of normal, abnormal, and critical findings
RCCS examination matrix
The percentages below are the approximate exam-score weights published by Cardiovascular Credentialing International (CCI). Use them to allocate study time, then adjust for your own weak areas.
3%
Providing Patient Care
Prepare for a safe, appropriate congenital echocardiographic examination by reviewing the order, indication, history, and pre-procedural needs.
- Triage incoming orders
- Review indications and appropriateness of the examination
- Review patient history
- Perform pre-procedural activities
35%
Acquiring Cardiac Images
Acquire and optimize the standard congenital echocardiographic windows while applying ultrasound physics and instrumentation principles.
- Acquire subcostal, left parasternal, apical, suprasternal, and right parasternal images
- Optimize images for anatomy, flow, and diagnostic quality
- Apply ultrasound physics and instrumentation principles
49%
Performing Disease Specific Examinations
The largest domain tests how the examination is adapted to identify congenital lesions and assess anatomy after surgery or catheter-based intervention.
- Adapt the patient examination to the suspected or known condition
- Identify congenital and acquired cardiac lesions
- Acquire post-surgical and post-interventional images after repair, palliation, or catheter intervention
10%
Acquiring Additional Echocardiographic Images
Acquire or assist with adjunct imaging used to answer questions beyond the standard transthoracic congenital examination.
- Assist with TEE and perform stress, ultrasound-enhanced-agent, and agitated-saline echocardiography
- Perform 3D echo and acquire strain images
- Assist with structural heart procedures involving the cath lab, balloon atrial septostomy, devices, or valves
3%
Processing and Communicating Preliminary Reports
Complete calculations and post-processing, communicate critical findings, and summarize the examination appropriately.
- Perform calculations and post-processing analysis
- Communicate critical results
- Perform post-examination communication and summarize findings
How to use this RCCS diagnostic
The 15 questions emphasize disease-specific examinations and cardiac image acquisition because those domains account for 84% of the official matrix. This is a short baseline rather than a pass prediction. Review every rationale, distinguish lesion-recognition gaps from acquisition or hemodynamic-calculation gaps, and follow with larger sets that include postoperative and post-interventional anatomy.
High-yield RCCS study priorities
Priority 1
Organize disease-specific study by anatomy and physiology
Nearly half of the matrix is disease-specific. For each lesion, be able to describe segmental anatomy, expected hemodynamics, optimal views, Doppler findings, associated abnormalities, and important complications.
Priority 2
Make image acquisition an active reasoning task
Standard views account for 35% of the matrix. Practise choosing the window, plane, transducer adjustment, Doppler method, and optimization step that best answers the clinical question rather than memorizing view labels alone.
Priority 3
Reconstruct repaired and palliated circulation
Study common repairs and staged palliation by tracing blood flow before and after intervention. Connect the operation or device to the views, residual lesions, gradients, shunts, and complications that must be assessed.
Priority 4
Integrate adjunct imaging and communication
Review when TEE, contrast, agitated saline, 3D, strain, stress, or procedural imaging adds value, then pair acquisition with accurate calculations, post-processing, and prompt communication of critical findings.
RCCS exam FAQ
How many questions are on the CCI RCCS exam?
CCI currently lists 170 questions: 150 scored questions and 20 unscored questions that are not identified during the examination.
How long is the RCCS exam?
The exam appointment is three hours. CCI allocates 2 hours 50 minutes to answer questions and 10 minutes to the tutorial and post-exam survey.
What is the largest RCCS exam domain?
Performing Disease Specific Examinations is the largest domain at approximately 49% of the exam, followed by Acquiring Cardiac Images at 35%.
Does the RCCS exam cover both pediatric and adult congenital ultrasound?
Yes. CCI describes the RCCS examination as intended for professionals working in pediatric and adult congenital cardiac ultrasound.
Is the RCCS exam offered year-round?
CCI states that the computer-based RCCS exam is administered year-round at Pearson Professional Centers, subject to test-center availability.
Does this diagnostic predict whether I will pass?
No. A 15-question diagnostic is a low-confidence baseline, not a validated pass prediction. Use it to identify review priorities and confirm current requirements with CCI.
Is MedPorium affiliated with CCI?
No. MedPorium is an independent education platform and is not affiliated with or endorsed by Cardiovascular Credentialing International.
Review and official source
Clinical reviewer: D. D. Ryan
Exam format and matrix information were checked against the CCI Registered Congenital Cardiac Sonographer credential page. Source reviewed October 10, 2026.
Ready to check your RCCS knowledge?
Take the free 15-question practice test to identify strengths and topics that need more review.