Presentations
- Chest pain
- Cyanosis:
- intermittent (e.g. cyanotic spells)
- persistent
- Dizziness/Syncope
- Heart failure
- Hypotension/Shock
- Murmur
- Palpitations/ Tachycardia/ Bradycardia
- Sepsis
Conditions
- Acquired heart disease:
- infective endocarditis
- Kawasaki disease
- myocarditis, including COVID-19 myocarditis
- rheumatic heart disease
- Cardiomyopathies:
- Heart disease associated with other diseases (e.g. connective tissue disorders, systemic lupus)
- Structural heart disease:
- Pericarditis, including cardiac
tamponade
- Primary cardiac arrythmias
- Pulmonary hypertension
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
Presentations
- Chest pain
- Cyanosis:
- intermittent (e.g. cyanotic spells)
- persistent
- Dizziness/Syncope
- Heart failure
- Hypotension/Shock
- Murmur
- Palpitations/Tachycardia/Bradycardia
- Sepsis
Conditions
- Cardiomyopathies:
- arrhythmogenic
- left ventricular non-compaction
- restrictive
- Systemic hypertension
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
- Aetiology, pathophysiology, diagnosis and management of the various
forms of congenital and acquired heart disease
- Clinical features of heart disease at different ages, from newborn
to young adult life
- Compensatory mechanisms which maintain cardiovascular
haemostasias
- Complications of pharmacological treatment in patients with congenital
heart disease
- Indications for and pharmacology of drugs used in the treatment
of congenital heart disease and heart failure
- Natural history and clinical presentation of patients with congenital
and acquired heart disease
- Optimise nutrition and manage failure to thrive caused by heart failure
- Physiology of control of cardiac output, including use of fluid and
inotrope support to optimise cardiac output and tissue oxygen delivery
- Principles of oxygen delivery and consumption
- Understanding of electrical conduction
Investigations
- Angiographic and haemodynamic findings at cardiac catheterisation
in congenital heart disease that presents with cardiac failure
- Chest x-ray (CXR)/electrocardiogram (ECG)
- Common blood tests as they relate to paediatric heart disease
- Role of additional imaging modalities including CT, MRI, and
nuclear medicine scans
- Role of echocardiography in determining cause and impacts
of haemodynamic lesions
Procedures
- Balloon atrial septostomy
- Pericardiocentesis
- Angiographic and haemodynamic findings at cardiac catheterisation
- Know indications for and principles of extracorporeal life support (ECLS)
- Know indications for extracorporeal mechanical support (ECMO)
- Know indications for referral for cardiac transplantation
- Know indications for referral for surgical interventions, including repair
- Management of acute presentations of congenital and acquired heart
disease (in particular duct-dependent lesions and medical management
of heart failure)
- Management of arrhythmias
- Management of congenital heart disease with cardiac catheterisation
(e.g. balloon valvuloplasty)
- Understanding of common surgical procedures for the management
of congenital heart disease
- Considerations of withdrawal of care (i.e.
significant structural heart disease requiring
palliation, including conversations with parents
or carers)
- Discuss problems of critically ill children with
parents or carers, including long-terms risks
and/or poor prognoses associated with genetic
syndromes
- Optimise care with involvement of intensive
care and other specialties
- Understand the trajectory of the underlying
illness with and without treatment, e.g. longterm neurological impacts/outcomes including
with and without treatment (i.e. risk to value
ratio)
