Presentations
- Breathlessness
- Bradycardia/Tachycardia
- Chest pain
- Chorea
- Cyanosis
- Dizziness/Syncope
- Fever/Sepsis
- Heart failure
- Joint pain
- Laboratory/Radiological abnormalities
- Murmurs
- Palpitations/Arrhythmia
- Rash
- Systemic hypertension
- Weight loss/gain
Conditions
- Aortopathies:
- Cardiac complications of systemic disease (infections, malignancy, autoimmune)
- Cardiac trauma
- Cardiomyopathy:
- dilated
- hypertrophic
- restrictive
- Infective/Inflammatory:
- endocarditis
- myocarditis
- pericarditis
- Kawasaki disease
- Orthostatic hypotension/Postural tachycardia
- Pulmonary hypertension (PHT)
- Rheumatic heart disease
- Systemic inflammatory disorder (e.g. COVID-19 related)
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
- Breathlessness
- Bradycardia/Tachycardia
- Chest pain
- Chorea
- Cyanosis
- Dizziness/Syncope
- Fever/Sepsis
- Heart failure
- Joint pain
- Laboratory/Radiological abnormalities
- Murmurs
- Palpitations/Arrhythmia
- Rash
- Systemic hypertension
- Weight loss/gain
Conditions
- Cardiac effects related to non-cardiac drugs, vaccination, other illnesses (e.g. drugs associated with long QT syndrome, COVID-19 vaccination)
- Cardiomyopathies:
- iatrogenic (e.g. post-chemotherapy)
- Coronary disease and myocardial ischaemia
- Infiltrative
- primary/secondary malignancy
- Ischaemic/perfusion abnormalities
- Lipid abnormalities:
- Pulmonary embolus
- Systemic hypertension (e.g. essential hypertension, hypertension associated with renal disease, drug-induced hypertension)
- Vasculitis
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 and pathophysiology of acquired cardiac diseases
- Diagnosis of acquired cardiac diseases
- knowledge of current guidelines and recommendations
- Investigation of aetiology of acquired cardiac diseases
- Natural history and clinical presentation of patients with acquired cardiac diseases, in particular the clinical features at different ages from newborn to adult life
Investigations
- 6-minute walk test/Exercise stress testing
- Ambulatory BP monitoring
- ECG/Holter monitor
- Imaging:
- chest x-ray
- MRI/CT
- ultrasound (e.g. bubble study, echocardiogram, renal)
- Laboratory tests:
- coagulation profile
- cultures/serology
- full blood count, urea and electrolytes, liver function testing
- inflammatory markers (CRP, ESR, PCT)
- lipid profile
- troponin
- vitamin levels
- Awareness of specific guidelines and recommendations of management (e.g. Kawasaki disease, rheumatic heart disease)
- Medical management:
- acute - suitability for life support (ventilation, ECMO)
- chronic - including follow-up, preventative, screening of comorbidities, family screening
- pharmacology - indications, monitoring, and side effects of pharmacological treatment in patients with acquired cardiac diseases
- Surgical management:
- perioperative management
- surgical procedures
- Incorporation of community resources and effective communication (e.g. community nurses, general practitioner, other specialists)
- MDT approach to investigations, treatment, and managing care (e.g. infectious diseases, immunology, haematology, rheumatology)
- Patient education of:
- management, including lifestyle changes and compliance to treatment
- prognosis and future treatment options (e.g. circulatory support/transplantation)
- understanding of disease
