Question 1

What questions are asked in an NHS Interventional Cardiology interview?

Accepted Answer

NHS Interventional Cardiology interviews usually mix values-based questions with scenarios specific to the role. Typical themes include motivation for interventional cardiology, primary PCI on call, cardiogenic shock, cardiac arrest and post-ROSC care, complications and tamponade and access site bleeding. Every interview panel writes its own questions, so practise the themes rather than memorising answers. The 8 free questions on this page cover a spread of them.

Question 2

What band is an NHS Interventional Cardiology job?

Accepted Answer

The questions on this page are pitched mainly at Specialty Registrar ST5+ to Consultant posts. The band for any job depends on the trust and the responsibilities of the post, so always check the advert and job description. Higher bands bring more questions on leadership, supervising others and improving the service.

Question 3

How should I prepare for an NHS Interventional Cardiology interview?

Accepted Answer

Read the job description and person specification closely, then prepare five or six real examples you can tell using the STAR method (situation, task, action, result). Revise GMC Good Medical Practice (or the GDC Standards for dental roles), consent and capacity, safeguarding, the duty of candour and patient safety. Research the trust's own values and the service you would join, and practise your answers out loud before the day.

Question 4

Which NHS values and standards should I mention in a Interventional Cardiology interview?

Accepted Answer

Link your examples to the NHS values from the NHS Constitution, such as compassion, respect and dignity, and working together for patients. For this role, panels will also expect you to understand GMC Good Medical Practice (or the GDC Standards for dental roles), consent and capacity, safeguarding, the duty of candour and patient safety. Show these through what you actually did rather than reciting lists.

Question 5

Are these real NHS Interventional Cardiology interview questions?

Accepted Answer

No. They are original practice questions written to reflect how NHS Interventional Cardiology interviews are typically run. Healthcare Interview Prep is independent and not affiliated with the NHS, and nobody can promise which questions you will be asked. Use the model answers to learn structure and content, then build answers from your own experience.

Question 6

What do I get if I unlock the full Interventional Cardiology question bank?

Accepted Answer

You get all 40 Interventional Cardiology practice questions. Each one has what the panel is assessing, a model answer, why the answer works, key points to include, common mistakes and the NHS values it links to. It is a one-off payment of £4.99 for 12 months' access, with no subscription.

Question 7

Why have you chosen interventional cardiology, and why do you want to work in this heart attack centre?

Accepted Answer

It started for me as a core trainee, on a night when I was the medical registrar's shadow and a man in his fifties came straight from the ambulance to the lab with an inferior STEMI. He was grey, sweating and convinced he was dying. Forty minutes later he was sitting up, pink, apologising to the nurses for swearing at them. I had never seen a treatment change someone's trajectory that quickly, and I have chased that feeling ever since. Since then, what has kept me in the specialty is less the drama and more the decision making around it. I enjoy the physiology, the imaging, and the fact that a good outcome depends on the whole system: the paramedic who recognises the ECG, the physiologist who spots the rhythm change, the radiographer who keeps the dose down and the nurse who notices the patient has gone quiet. As a registrar I have done the full range of on call work, and I have learned that the hardest calls are often the ones where the right answer is not to go to the lab. I chose to apply here for specific reasons. You run a busy 24 hour primary PCI service for a large network of district general hospitals and ambulance services, so I would see a broad range of presentations, including shock and out of hospital arrest. You have on site cardiac surgery and a weekly heart team meeting, which matters to me because I want my complex decisions tested by surgeons and imagers. I also read your published door to balloon data and the work your nurses did on radial first access,…

Question 8

You are the interventional cardiologist on call and an ambulance crew transmits an ECG showing an anterior STEMI from a patient 50 minutes away. Can you talk us through what you would do?

Accepted Answer

The first thing I do is look at the transmitted ECG myself while the crew is still on the line. I want to confirm ST elevation in a coronary distribution, look for reciprocal change, and make sure there is nothing suggesting a mimic such as pericarditis or an old aneurysm pattern. I take a short SBAR history from the paramedic: time of symptom onset, haemodynamics, rhythm, any arrest, whether the patient is anticoagulated, allergies and anything that changes the plan, such as a known frailty or advance decision. If it is a STEMI I accept the patient directly to the lab, bypassing the emergency department, and ask the crew to give the loading medications set out in our network protocol. I activate the on call team through switchboard so that the nurse, physiologist and radiographer are travelling at once, and I document the call time because door to balloon and call to balloon times are recorded in our audit and they matter for the patient. While they travel I think ahead. I check the electronic record for previous angiograms, renal function or prior grafts. I plan radial access unless there is a reason not to, and I think about what could go wrong: an anterior infarct can deteriorate into shock or VF, so I want the defibrillator ready and I want to know which anaesthetist and which intensive care team to call. If the patient arrives unstable I will take an ABCDE approach with the team before we start, rather than rushing to the table. When the patient arrives I do a brief…

Question 9

During primary PCI, shortly after stent deployment, the patient becomes hypotensive and agitated, and you see contrast outside the vessel. How do you manage this?

Accepted Answer

My immediate thought would be coronary perforation with developing tamponade, and I would say that out loud so the whole team is working on the same problem. I would call for help straight away: a second operator if available, the anaesthetist and, depending on the centre, cardiac surgery to be made aware early. I would ask the nurse to note the time and start scribing, and the physiologist to call out pressures and rhythm. The first technical step is to seal the leak, usually by inflating a balloon at the site of perforation to stop ongoing bleeding into the pericardium, while the team supports the circulation with fluids and vasopressors per the anaesthetist's direction. I would ask for a bedside echo to confirm an effusion, and if there is tamponade physiology I would proceed to pericardiocentesis, which is something I am trained to do in the lab. I would think carefully about anticoagulation, discussing reversal with the team if appropriate, and I would weigh up definitive options such as a covered stent or, for a distal wire perforation, embolisation, depending on the anatomy and what the lab has available. Throughout, I would keep communication calm and closed loop: I ask for one thing, it is repeated back, and it is confirmed when done. If the leak cannot be controlled, the surgical team needs to be in the room or the patient needs to go to theatre, and I would rather make that call early than late. Afterwards I would make sure the patient is monitored closely on the…

Question 10

How do you approach consent for elective PCI, and what does informed consent mean to you after the 2015 UK Supreme Court ruling on consent?

Accepted Answer

For me, consent starts well before the patient arrives in the lab. Ideally the conversation happens in clinic or on the ward, with time for questions, and on the day I am confirming that understanding rather than starting from scratch. A patient lying on a trolley in a gown, already cannulated, is not in a good position to weigh up options. Since the 2015 Supreme Court consent ruling, the test is not what a reasonable doctor would mention but what this particular patient would want to know, and what any reasonable person in their position would consider significant. So I start by asking what they understand about their condition and what they hope the procedure will achieve. For stable angina that matters a great deal, because PCI improves symptoms but for many patients it does not reduce the risk of death or heart attack compared with good medical therapy. If someone thinks a stent will make them live longer, I need to correct that kindly. I then explain the realistic alternatives: continuing or optimising medication, PCI, and for some anatomy, bypass surgery, which may have been discussed at heart team. I go through the common and the serious risks in plain language, including bleeding and access site problems, stroke, kidney injury from contrast, the need for emergency surgery and the rare risk of death, and I tailor what I emphasise to the person. A musician might want to hear about radial artery occlusion, someone with kidney disease about contrast. I also explain the…

Question 11

Tell us about a time you worked closely with the cath lab team to manage a difficult case. What was your role and what did you learn?

Accepted Answer

During my registrar year we had an elderly woman come in out of hours with a STEMI, already in complete heart block and hypotensive. The lab team that night was a senior cardiac physiologist, an experienced cath lab nurse, a fairly new radiographer and me as the first operator, with my consultant on the way in. The task was to get her reperfused quickly while managing her rhythm and blood pressure, and I knew I could not hold all of that in my head at once. So before we scrubbed I did a thirty second huddle. I said what I thought the culprit was likely to be, that the priority was a temporary pacing wire, and I asked the physiologist to own the rhythm and pressures and tell me immediately about any change. I asked the nurse to manage drugs and keep a running time log, and I checked with the radiographer that she was comfortable with the projections and settings, because I could see she was new. During the case the physiologist noticed a subtle loss of capture before I did and called it out, and the nurse suggested we start a vasopressor while I was focusing on the wire. Both were right. The radiographer flagged that our dose was climbing during pacing wire positioning and suggested a lower frame rate, which I accepted. We opened a right coronary occlusion, rhythm recovered, and she went to the coronary care unit stable. The result was a good outcome, but what I took away was how much the huddle mattered. Assigning ownership meant people spoke up without waiting to be asked.…

Question 12

You notice that a senior colleague regularly skips the team safety pause in the cath lab, saying it slows things down. What would you do?

Accepted Answer

I would take it seriously, because the safety pause exists precisely for the moments when everyone feels confident. Wrong side access, missed allergies and unrecognised anticoagulation are exactly the kind of errors it catches, and skipping it also tells the rest of the team that their voice is not needed. In the moment, if I was in the room, I would simply ask for the pause myself: something like, before we start can we just do the time out, it will take thirty seconds. Framing it as routine rather than a challenge usually works, and it gives the nurse or radiographer cover to do the same. I would never let a case start where I had a specific safety worry because of hierarchy. I would then find a private moment to talk to the colleague directly. I would be curious rather than accusatory: ask why they feel it slows things, acknowledge that in a primary PCI time matters, and explain that our local standards based on NatSSIPs 2 expect the pause for every invasive procedure, and that the team value it. Often the issue is how the checklist is run, so I might suggest we work together to make it quicker and more meaningful, perhaps by focusing on the few items that really matter. If the behaviour continued, I would escalate. I would speak to the lab manager and the clinical lead, and if there had been a near miss I would report it through our incident system so it can be learned from under PSIRF. If I felt the concern was not being heard, I know I could go to the Freedom to Speak…

Question 13

You are called about a patient resuscitated from an out of hospital cardiac arrest who is now ventilated with no ST elevation on the post-ROSC ECG. Would you take them straight to the lab?

Accepted Answer

Not automatically. If the post-ROSC ECG shows no ST elevation, the randomised evidence, including COACT and TOMAHAWK, did not show a benefit from routine immediate angiography compared with a delayed or selective strategy. So my starting point is a careful assessment rather than a reflex trip to the lab. I would want to understand the arrest: was it witnessed, was there bystander CPR, what was the initial rhythm, how long until ROSC, and what was happening beforehand. Chest pain before collapse, a shockable rhythm and a clear ischaemic picture push me towards a coronary cause. I would look at the ECG again for subtle changes and posterior involvement, review the echo for regional wall motion abnormality, and think about other causes such as pulmonary embolism, aortic dissection, intracranial haemorrhage or a primary arrhythmia. A CT may be more urgent than angiography. I would discuss the patient jointly with the intensive care team, because their priorities around ventilation, temperature control and neuroprognostication run alongside mine. If there is ongoing ischaemia, haemodynamic or electrical instability, or a strong suspicion of an acute occlusion, I would take them to the lab promptly. If they are stable with no clear coronary cause, angiography can usually be done later on the unit's next list once they are settled. Because the patient lacks capacity, any decision has to be in their best interests under the Mental Capacity Act. I would speak to the family as soon…

Question 14

A 72 year old man with diabetes and three vessel coronary disease tells you he wants stents, not bypass surgery. How do you approach the decision?

Accepted Answer

I would start by understanding why he prefers stents. Often it is fear of a big operation, a relative who had a difficult recovery, or worries about being away from a spouse he cares for. Those are legitimate reasons and they shape how I frame the conversation. Clinically, this is exactly the kind of patient who should be discussed at the heart team meeting with a surgeon and, ideally, an imaging cardiologist. In people with diabetes and multivessel disease, trials such as FREEDOM suggested better long term outcomes with surgery, particularly fewer repeat procedures and heart attacks, though with a higher early stroke risk. But the overall picture depends on his anatomy and complexity, his left ventricular function, his frailty, lung function, kidney function and his own goals. At heart team I would present his preference clearly alongside the anatomy, so the recommendation reflects him and not just the angiogram. I would then sit down with him, with a family member if he wishes, and go through the heart team recommendation in plain language. I would explain what each option offers: surgery as a bigger upfront operation with a longer recovery but often more complete and durable revascularisation, PCI as a quicker recovery but a greater chance of needing further procedures, and medical therapy as a valid choice for some. I would offer to arrange for him to meet the surgeon, because hearing it from them often addresses fears directly. If, having understood all of this, he…

Interventional Cardiology Interview Questions & Answers

Quick answer

Free NHS interview questions and model answers

Question 1: Why have you chosen interventional cardiology, and why do you want to work in this heart attack centre?

Question 2: You are the interventional cardiologist on call and an ambulance crew transmits an ECG showing an anterior STEMI from a patient 50 minutes away. Can you talk us through what you would do?

Question 3: During primary PCI, shortly after stent deployment, the patient becomes hypotensive and agitated, and you see contrast outside the vessel. How do you manage this?

Question 4: How do you approach consent for elective PCI, and what does informed consent mean to you after the 2015 UK Supreme Court ruling on consent?

Question 5: Tell us about a time you worked closely with the cath lab team to manage a difficult case. What was your role and what did you learn?

Question 6: You notice that a senior colleague regularly skips the team safety pause in the cath lab, saying it slows things down. What would you do?

Question 7: You are called about a patient resuscitated from an out of hospital cardiac arrest who is now ventilated with no ST elevation on the post-ROSC ECG. Would you take them straight to the lab?

Question 8: A 72 year old man with diabetes and three vessel coronary disease tells you he wants stents, not bypass surgery. How do you approach the decision?

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About this NHS interview question bank

Interventional Cardiology NHS interview: frequently asked questions