Presentations
- Cardiac arrest
- Chest pain
- Dyspnoea
- Hypotension
- Lightheadedness/ Presyncope
- Oliguria
- Syncope
Conditions
- Acute myocardial infarction
(AMI) complicated by
cardiogenic shock
- Acute decompensated heart
failure
- Cardiac arrest
- Cardiac tamponade
- Haemodynamically unstable
arrhythmias:
- bradyarrhythmias
- tachyarrhythmias
- Severe myocarditis
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Conditions
- Aortic dissection
- Complications of late-presenting
acute myocardial infarctions
(e.g. mechanical complications,
ventricular septal rupture
papillary muscle rupture with
severe MR cardiomyopathy)
- Complications of valvular
disease severe aortic stenosis
- Respiratory failure
- Septic shock
- Thromboembolism
(e.g. saddle embolus,
large/multiple emboli with
right heart sequelae)
For each presentation and condition, Advanced Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, prevalence, pathophysiology, and clinical science
- take a comprehensive clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients and their quality of life when developing a management plan
Manage
- provide evidence-based management
- prescribe therapies tailored to patients' needs and conditions
- recognise potential complications of disease and its management, and initiate preventative strategies
- involve multidisciplinary teams
Consider other factors
- identify individual and social factors and the impact of these on diagnosis and management
Clinical sciences
- Cardiac arrest
- Understand and describe cardiac and non-cardiac causes of cardiac
arrest, and principles of cardiopulmonary resuscitation
- Understand and describe current Australian Resuscitation Council
(ARC) guidelines on cardiopulmonary resuscitation and management
of an acutely unwell patient
- Understand and describe role of non-invasive and invasive ventilation
respiratory failure and acute heart failure
Key medications
- Indications for and limitations of anti-arrhythmic agents
(for tachyarrhythmias)
- Indications for and limitations of chronotropic agents
(for bradyarrhythmias)
- Indications for and limitations of inotropes and vasopressors
- Indications for thrombolysis (for ST elevation myocardial infarctions,
and haemodynamically unstable pulmonary emboli)
- Pharmacology of drugs currently used in the treatment of heart
failure, including inotropes and vasopressors
Investigations
- Blood tests, including blood gas analysis
- Cardiac magnetic resonance imaging
- Consider the role of CT aortography in specific emergent
conditions (e.g. surgical work-up for aortic dissection, to
diagnose pulmonary embolus)
- Echocardiography (transthoracic and transoesophageal)
- Electrocardiography
- Invasive cardiac catheterisation, including left and right heart
catheterisation
Procedures
- Coronary angiography and/or percutaneous intervention
- Direct current cardioversion (DCR)
- Mechanical circulatory supports (e.g. extra-corporeal membrane
oxygenation, intra-aortic balloon pumps, left ventricular assist devices)
- Pacemakers/Temporary pacing wires (indications for)
- Percutaneous structural interventions (e.g. balloon aortic valvuloplasty
and/or transcatheter aortic valve implantation)
- Pericardiocentesis
- Referral for surgical interventions, including valve surgery, cardiac
transplantation, and assist devices
- Right heart catheterisation
- Transthoracic and transoesophageal echocardiograms
General management considerations
- Goals of therapy
- Impact of comorbidities on diagnosis and management
- Individual patient clinical indications to determine patients' needs,
and the most appropriate approach to investigations and care
- Patient demographics, including geographical location, socioeconomic
status, ethnicity, and cultural background, and the considerations
when managing and following up these patients (e.g. travel from
rural to metropolitan areas)
- The timing of decisions and risks for the individual patient
Specific management considerations
- Rehabilitation/Referral to rehab likely useful – especially if prolonged
hospitalisation/ICU admission
