Presentations
- Arrhythmias
- Cardiac arrest/sudden cardiac death
- Chest pain
- Cyanosis
- Genetic abnormality
- Heart failure
- Murmur
- Palpitations
- Seizures
- Stridor
- Swallowing difficulties
- Syncope/Pre-syncope
Conditions
- Cyanotic heart disease:
- Ebstein anomaly
- pulmonary atresia (PA)
- Tetralogy of Fallot (ToF)
- tricuspid atresia
- total anomalous pulmonary venous drainage (TAPVD)
- transposition of the great arteries (TGA)
- Non-cyanotic heart disease:
- coronary artery abnormalities:
- anomalous coronary artery origins, including left coronary artery from the pulmonary artery (ALCAPA)
- coronary artery aneurysms
- coronary artery fistulae
- obstructive lesions:
- aortic stenosis
- arch abnormalities:
- coarctation of the aorta (CoA)
- hypoplastic arch
- interrupted aortic arch
- vascular rings
- hypertrophic cardiomyopathy
- pulmonary stenosis
- shunt lesions:
- aortopulmonary window
- atrial septal defect (ASD)
- atrioventricular septal defect (AVSD)
- patent ductus arteriosus (PDA)
- ventricular septal defect (VSD)
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 patients17 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
- Absent pericardium
- Complex/Single ventricle congenital heart disease
- Heterotaxy/Isomerism
- Primary cardiac tumours
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 patients17 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
- Understand the clinical features which can help differentiate these presentations from non-cardiac causes of similar presentations, including syncope and seizures
- Understand the clinical presentations of structural heart disease, including the types presenting with chest pain, palpitations, or syncope
- Understand the impact of lung pathology on cardiac presentation and severity
- Understand the physiology and haemodynamic impact of structural cardiac defects
Investigations
- CXR in the diagnosis and assessment of structural heart disease (abnormalities in cardiac position and cardiac silhouette)
- Echocardiography in the diagnosis and assessment of haemodynamic impact of structural heart disease
- Indications for and interpretations of cardiac event recorders, exercise tests, and Holter monitors
- Interpretation of the 12-lead ECG findings, identifying substrate for cardiac arrhythmias, hypertrophy, and ischaemia
- Screening of other systems (e.g. liver function tests)
- Use and interpretation of additional imaging modalities, including CT, MRI, and nuclear medicine scanning
Procedures
- Indications for and risks of transoesophageal echocardiography in the diagnosis of congenital cardiac defects
- Catheter-based procedures:
- type and timing of catheter interventions in the management of structural heart disease
- Indications for referral for heart or heart-lung transplantation, and provision of local care following transplantation
- Surgical procedures:
- assess children with cardiac disease prior to non-cardiac surgery, and advise on fitness for such surgery and any precautions or cardiac treatment required
- type and timing of surgical treatment of cardiac lesions
- Explain the nature of the diagnosis to patients, and family or carers
- Genetic risks (e.g. pregnancy planning)
- Transitions to adulthood and longitudinal care
