Key presentations and conditions
Basic Trainees will have a comprehensive depth of knowledge of these presentations and conditions.
Presentations
- Breathlessness
- Chestpain
- Oedema
- Palpitations
- Syncope
Conditions
- Acute coronary syndromes:
- non-ST elevation myocardial infarction (NSTEMI)
- ST-elevation myocardial infarction (STEMI)
- Acute pericarditis
- Aortopathy
- Cardiac arrhythmias:
- atrial fibrillation
- atrial flutter
- atrioventricular node conduction block
- bundle-branch and fascicular block
- sinus node dysfunction
- supraventricular tachycardia
- ventricular tachycardia
- Heart failure:
- preserved ejection fraction
- reduced ejection fraction
- valvular
- Hypertension:
- pulmonary
- systemic, primary and secondary
- Infective endocarditis
- Lipoprotein disorders
- Rheumatic heart disease
- Stable ischaemic heart disease
- Valvular heart disease
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Less common or more complex presentations and conditions
Basic Trainees will understand these presentations and conditions. Basic Trainees will understand the resources that should be used to help manage patients with these presentations and conditions.
Conditions
- Advanced arrhythmias and channelopathies:
- arrhythmogenic right ventricular cardiomyopathy
- Brugada syndrome
- long QT syndrome
- Wolff-Parkinson-White syndrome
- Cardiomyopathy:
- dilated
- hypertrophic
- restrictive
- Cardiovascular manifestations of systemic and chronic disease, such as amyloidosis, diabetes mellitus, HIV, renal disease, rheumatoid arthritis, systemic lupus erythematosus, and thyroid disease
- Cholesterol embolus
- Congenital heart disease:
- atrial and ventricular septal defects
- coarctation of the aorta
- Eisenmenger syndrome
- Marfan syndrome
- tetralogy of Fallot (TOF)
- transposition of the great arteries
- Pericardial disease:
- constrictive pericarditis
- Dressler syndrome
- pericardial effusion and tamponade
- Peripheral vascular disease
For each presentation and condition, Basic Trainees will know how to:
Synthesise
- recognise the clinical presentation
- identify relevant epidemiology, pathophysiology, and clinical science
- take a relevant clinical history
- conduct an appropriate examination
- establish a differential diagnosis
- plan and arrange appropriate investigations
- consider the impact of illness and disease on patients1 and their quality of life
Manage
- provide evidence-based management
For less common or more complex presentations and conditions the trainee must also seek expert opinions - 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
Epidemiology, pathophysiology and clinical sciences
Basic Trainees will describe the principles of the foundational sciences.
- Anatomy and physiology of the cardiovascular system
- Coronary blood flow
- Lipid metabolism
- Pathophysiology of heart failure
- Pharmacology of major drug classes used:
- antiarrhythmic drugs
- anticoagulant drugs
- antiplatelet drugs
- beta blockers
- calcium channel blockers
- diuretics
- lipid-modifying agents
- nitrates and antianginals
- renin-angiotensin-aldosterone inhibitors
- Regulation of arterial blood pressure and the role of the renin-angiotensin-aldosterone system
- Regulation of cardiac output
- Risk markers and primary prevention of cardiovascular disease
- Vascular biology and the pathophysiology of atherosclerosis
Investigations, procedures and clinical assessment tools
Basic Trainees will know the indications for, and how to interpret the results of these investigations, procedures, and clinical assessments tools. Basic Trainees will know how to explain the investigation, procedure, or clinical assessment tool to patients, families, and carers.
Investigations
- Ankle-brachial index and arterial Dopplers
- Blood tests, such as troponin and B-type natriuretic peptide
- Cardiac MRI
- Coronary angiography
- CT coronary angiography and coronary calcium score
- Duplex ultrasound scans
- Echocardiography, including stress echocardiography
- Electrocardiography
- Exercise stress testing
- Holter monitoring
- Myocardial perfusion scans
Procedures
- Cardiac resynchronisation therapy (know indications for)
- Defibrillators (know indications for)
- Pacemakers (know indications for)
Important specific issues
Basic Trainees will identify important specialty-specific issues and the impact of these on diagnosis and management.
- Restrictions on driving following cardiac illness, as identified by the statutory body
- The incidence of, and the risk factors for, cardiovascular disease in individuals and patient groups, such as:
- elderly patients
- Māori and Aboriginal and Torres Strait Islander peoples
- patients with comorbidities
- patients with risk factors for atherosclerotic vascular disease
- pregnant patients
- References to patients in the remainder of this document may include their families or carers.