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Internal Diseases (Cardiology)
Study Course Description
Course Description Statuss:Approved
Course Description Version:5.00
Study Course Accepted:29.09.2021 09:18:34
| Study Course Information | |||||||||
| Course Code: | ISK_006 | LQF level: | Level 7 | ||||||
| Credit Points: | 6.00 | ECTS: | 9.00 | ||||||
| Branch of Science: | Clinical Medicine; Internal Medicine | Target Audience: | Medicine | ||||||
| Study Course Supervisor | |||||||||
| Course Supervisor: | Oskars Kalējs | ||||||||
| Study Course Implementer | |||||||||
| Structural Unit: | Department of Internal Diseases | ||||||||
| The Head of Structural Unit: | |||||||||
| Contacts: | Riga, Hipokrata street 2, isk rsu[pnkts]lv. tel. +371 67042338 | ||||||||
| Study Course Planning | |||||||||
| Full-Time - Semester No.1 | |||||||||
| Lectures (count) | 8 | Lecture Length (academic hours) | 2 | Total Contact Hours of Lectures | 16 | ||||
| Classes (count) | 16 | Class Length (academic hours) | 2 | Total Contact Hours of Classes | 32 | ||||
| Total Contact Hours | 48 | ||||||||
| Full-Time - Semester No.2 | |||||||||
| Lectures (count) | 8 | Lecture Length (academic hours) | 2 | Total Contact Hours of Lectures | 16 | ||||
| Classes (count) | 16 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 48 | ||||
| Total Contact Hours | 64 | ||||||||
| Study course description | |||||||||
| Preliminary Knowledge: | normal anatomy, histology, normal physiology, biochemistry, basics of medical physics, biology and genetics, basics of internal medicine from the 4th semester course. | ||||||||
| Objective: | - to acquire knowledge of the principles of deontology; - to acquire knowledge of subjective and objective examination methods – survey, inspection, palpation, percussion, auscultation, and interpretation results; - to teach students learn to assess laboratory and instrumental data; - to provide students with the basics of writing a medical history; - to encourage students in clinical thinking and decision-making. | ||||||||
| Topic Layout (Full-Time) | |||||||||
| No. | Topic | Type of Implementation | Number | Venue | |||||
| 1 | Cardiovascular system – structure and function. Anamnesis, physical investigation – importance and significance in real praxis. Elements of cardiovascular system, common signs of pathology. Intracardial hemodinamic: mechanisms of heart sounds and murmurs, informative significance. Heart valves. | Lectures | 1.00 | auditorium | |||||
| 2 | Congenital and acquired heart diseases. | Lectures | 1.00 | auditorium | |||||
| 3 | Heart electrophysiology, basic aspects of ECG (principles, leads, elements of ECG, background of analysis of heart rhythm disturbances and propagation defects). | Lectures | 1.00 | auditorium | |||||
| 4 | Signs of heart rhythm disturbances in ECG. Exercise tests (veloergometric tests, tredmil, 6 min.walking tests), informative value. | Lectures | 1.00 | auditorium | |||||
| 5 | Instrumental investigation methods in cardiology. Assessment of mechanical function of Heart (output, systolic and diastolic dysfunction), concept of remodelation, dilatation, hypertrophy. EchoCG principles for investigation of heart structures and function. Other imaging methods for diagnostic in cardiology (CT, MRI, PET). Invasive investigation in cardiology. | Lectures | 1.00 | auditorium | |||||
| 6 | Acute and chronic heart failure, pathophysiological mechanisms, ABCD and NYHA classification, common risks, systolic and diastolic heart failure. Value of clinical and instrumental investigation. | Lectures | 1.00 | auditorium | |||||
| 7 | Arrhythmias. Arrhythmias as specific diseases in cardiology. Arrhythmias as clinical manifestation. | Lectures | 1.00 | auditorium | |||||
| 8 | Typical complaints and anamnesis if cardiovascular patients. Investigation: inspectio, palpatio, percussio, auscultatio. Data with inspectio and palpatio about clinical condition of cardiovascular patients. | Classes | 1.00 | clinical base | |||||
| 9 | Cardiac auscultation. Principles, methods. Data with auscultation about clinical condition of cardiovascular patients. Heart sounds, variants of heart sounds. Murmurs of heart. Arterial pressure. Assessment of arterial pressure (e.g. Home BP, daily BP etc.). What is arterial hypertension? | Classes | 1.00 | clinical base | |||||
| 10 | ECG – background, ECG – electrical axis, hypertrophy’s, interpretation of ECG. | Lectures | 1.00 | auditorium | |||||
| Classes | 1.00 | clinical base | |||||||
| 11 | ECG – myocardial blood flow and metabolic changes. | Classes | 1.00 | clinical base | |||||
| 12 | ECG - heart rhythm disturbances and conduction changes. Summary of topics | Classes | 1.00 | clinical base | |||||
| 13 | Cardiovascular system: instrumental methods of investigation. Stress – Tests, exercise tests, 6 min. walking tests, tredmil, myocardial perfusion scintigraphy. Imaging methods in cardiology – ECHO Cg, computer tomography, magnetic resonance imaging etc. | Classes | 1.00 | clinical base | |||||
| 14 | Assessment of potential vascular problems. Assessment of coronary artery (CT – angiography, coronary angiography, principle of IVUS). Assessment of arteries: endothelium, elasticity, structure. Pulse wave velocity. Assessment of carotid arteries. Methods of measurement of central venous pressure. | Classes | 1.00 | clinical base | |||||
| 15 | Clinical assessment of congenital heart diseases. Clinical assessment of valvular heart diseases. Frequently concurrent congenital and acquired heart diseases, signs, symptoms, pathophysiology, diagnostic methods. | Classes | 1.00 | clinical base | |||||
| 16 | Clinical assessment of congenital and acquired heart diseases with imaging methods (ECHO CG, CT, MRI etc.). Informative relevance of ECG in early diagnostic of congenital and acquired heart disease. | Classes | 1.00 | clinical base | |||||
| 17 | Methods of treatment of valvular and congenital heart disease. Surgical and mini-invasive approache. Valve replacement, valvular repair, closure of defects, radical surgery, palliative surgery). Summary of topics | Classes | 1.00 | clinical base | |||||
| 18 | Concept of arrhythmias. Classification, types, assessment of clinical and prognostic importance. Role of ECG in diagnostic approach. | Classes | 1.00 | clinical base | |||||
| 19 | Arrhythmias. Types of paroxysmal tachyarrhythmia, clinical assessment. Types of life threatening arrhythmias, diagnostic approaches. | Classes | 1.00 | clinical base | |||||
| 20 | Arrhythmias. Atrial Fibrillation and Atrial Flutter – risks, reasons, classification, clinical variations. Conduction system disturbances, clinical assessment, assessment by ECG. Bradyarrhythmias. Types. clinical assessment, assessment by ECG Summary of topics | Classes | 1.00 | auditorium | |||||
| 21 | Cardiomyopathies. Classification. Unclassified cardiomyopathies. Pathophysiology | Classes | 1.00 | clinical base | |||||
| 22 | Chronic Heart failure. Mechanisms of pathophysiology, classification by ABCD and NYHA, risks, assessment of systolic and diastolic function – clinical data, laboratory data (BNP, NT-proBNP, others NP), ECG data, imaging data. | Classes | 1.00 | clinical base | |||||
| 23 | Acute heart failure. Mechanisms of pathophysiology, clinical signs, variants. Oedoma pulmonary, cardiogenic shock, central venous pressure, pressure of seizure of pulmonary capillary. Summary of topics. | Classes | 1.00 | clinical base | |||||
| 24 | Atherosclerosis as systemic disease, risk factors of cardiovascular disease, development of atherosclerosis, variants of clinical manifestation. Principles of treatment. | Lectures | 1.00 | auditorium | |||||
| 25 | Arterial hypertension. Primary and secondary arterial hypertension. Clinical assessment – risk factors, target organ damages, complication. Principles of pharmacological and non-pharmacological treatment. Choice of pharmacotherapy. | Lectures | 1.00 | auditorium | |||||
| 26 | Coronary heart disease: epidemiology, background, mechanisms, different forms with diff-diagnosis, evaluations, principles of treatment. | Lectures | 1.00 | auditorium | |||||
| 27 | Cardiomyopathies. Concept of primary and secondary cardiomyopathies. Myocarditis. | Lectures | 1.00 | auditorium | |||||
| 28 | Inflammatory heart diseases (endocarditis, pericarditis), diagnosis (clinical and laboratorial evaluation, EchoCG, invasive methods etc.). Principles of treatment inflammatory heart diseases | Lectures | 1.00 | auditorium | |||||
| 29 | Atrial Fibrillation. Mechanisms, risk factors, perspectives. Principles of treatment. Sudden cardiac death. Primary and secondary prophylaxis. | Lectures | 1.00 | auditorium | |||||
| 30 | 7. Thromboembolism, Risk factors. Pulmonary embolism. Pulmonary hypertension. | Lectures | 1.00 | auditorium | |||||
| 31 | Arterial Hypertension. Primary and secondary hypertension. Clinical assessment – risk factors, organ system damage, complication. | Classes | 1.00 | clinical base | |||||
| 32 | Arterial Hypertension: treatment – principles of non-pharmacological and pharmacological therapy. Choice of pharmacotherapy, statement of pharmacotherapy. | Classes | 1.00 | clinical base | |||||
| 33 | Hypertensive crisis. Resistant hypertension, pseudoresistant hypertension. Treatment of secondary hypertension. Summary of topics. | Classes | 1.00 | clinical base | |||||
| 34 | Coronary heart disease. Risk factors epidemiology, pathophysiology. Chronic coronary heart disease. Angina pectoris, types of angina, classifications, diagnostic, investigation, treatment. | Classes | 1.00 | clinical base | |||||
| 35 | Acute coronary syndrome. Clinical development and variants. Myocardial infarction, classification, mechanisms, types of myocardial infarction. Approaches of treatment acute coronary syndrome. Different clinical situation, clinical cases, diagnostic, invasive or conservative approach. | Classes | 1.00 | clinical base | |||||
| 36 | Complications of myocardial infarction. Risk after myocardial infarction, assessment of risk, methods, importance of different investigations. Treatment options after myocardial infarction, implantable cardioverter - defibrillator. | Classes | 1.00 | clinical base | |||||
| 37 | Treatment of coronary heart disease. Invasive or conservative approach (pharmacology, PCI, CABG, hybrid strategy) Summary of topics. | Classes | 1.00 | clinical base | |||||
| 38 | Treatment of chronic heart failure: principles of non-pharmacological and pharmacological therapy. Treatment of acute heart failure. | Classes | 1.00 | clinical base | |||||
| 39 | Inflammatory heart disease – endocarditis, pericarditis. Diagnostic approaches – clinical, laboratory, ECHO CG etc. Principles of treatment inflammatory heart diseases. Treatment of endocarditis. Prophylaxis of endocarditis. | Classes | 1.00 | clinical base | |||||
| 40 | Cardiomyopathies – classification, clinical variation. Myocarditis – classification, clinical variation. Unclassified cardiomyopathies. Pathophysiology, methods of treatment. High risk cardiomyopathies, principles of treatment. Non-pharmacological approaches. CRT, CRT-D, ICD, alcohol-ablation, heart transplantation. Summary of topics – inflammatory cardiac diseases and cardiomyopathies. | Classes | 1.00 | clinical base | |||||
| 41 | Arrhythmias I. Supraventricular tachyarrhythmia. Pharmacological and non-pharmacological treatment. | Classes | 1.00 | clinical base | |||||
| 42 | Arrhythmias II. Pharmacological and non-pharmacological treatment of atrial fibrillation. Prophylaxis of thromboembolism. | Lectures | 1.00 | auditorium | |||||
| Classes | 1.00 | clinical base | |||||||
| 43 | Arrhythmias III. Ventricular arrhythmias. Inherited arrhythmias. Pharmacological and non-pharmacological treatment | Classes | 1.00 | clinical base | |||||
| 44 | Arrhythmias IV. Bradyarrhythmias. Pharmacological and non-pharmacological treatment. Summary of topics. | Classes | 1.00 | clinical base | |||||
| 45 | Thrombosis. Thrombosis in venous system. Deep vein thrombosis. Thromboembolia of pulmonary artery Risk of thrombosis. Pulmonary hypertension. | Classes | 1.00 | clinical base | |||||
| 46 | Final class of semester. Clinical cases | Classes | 1.00 | clinical base | |||||
| Assessment | |||||||||
| Unaided Work: | Independent individual work - patient examination, analysis and interpretation of investigation results, filling in of medical history. Preparation of study material for the course. Improvement of existing learning material. | ||||||||
| Assessment Criteria: | - clinical situations with investigation results - 40%; - multiple choice questions (OSCE) - 30% of the total mark; - electrocardiography : examination results and their interpretation - 30%. | ||||||||
| Final Examination (Full-Time): | Exam (Written) | ||||||||
| Final Examination (Part-Time): | |||||||||
| Learning Outcomes | |||||||||
| Knowledge: | - Demonstrate orientation in newest medical technologies, examination methods, scientific disciplines. - Collect the anamnesis, sequentially arrange it, identify possible risk factors of the disease. - Considering the patient's investigation data (check-up, palpation, percussion, auscultation, assessing instrumental finding results) identify possible level of pathology. - Analysis of the obtained information to evaluate the pathological degree and the corresponding risks. - Be competent in pathological processes under consideration and be able to analyze those aspects of pathophysiology | ||||||||
| Skills: | - Be able to communicate with patients, their relatives, colleagues, other people or organizations involved in health care. - Patient's complaints and anamnesis; - Perform physical examination of the patient with palpation, percussion and auscultation methods and methods derived from those. - Determine the peripheral pulse, heart rate, respiratory rate and arterial pressure indicators, relate it to a particular clinical situation and link it with the overall investigation process. - Be competent in ECG results. - Be competent in instrumental examination results and their indications (load tests, imaging methods, invasive diagnostic techniques, contrast tests) used in cardiology practice. - Be competent in the diagnosis of heart disease, modern heart disease treatments (pharmacotherapy, surgery, mini-invasive methods); be able to interpret auscultation findings, imaging data. - Be able to evaluate electrocardiographic findings in a variety of heart rhythm disorders. Be competent in assessment of different risk degrees of arrhythmia. - Be competent in the diagnosis of different cardiomyopathies, be able to interpret auscultation findings, imaging data, be competent in modern diagnostic options of cardiomyopathy (nuclear magnetic resonance, genetic examinations, implantable rhythm recorders). - Be competent in the diagnosis of acute and chronic heart insufficiency, be able to interpret auscultation findings, imaging data, and be competent in modern diagnostic options and pathophysiological comprehension. - Be able to summarize acquired symptoms and present the diagnosis and medical history. | ||||||||
| Competencies: | - Evaluation of acquires symptoms, linking them with pathological processes in the patient's body. - Interpret basic imaging (echocardiography, CT, MRI) data. - Explain the necessity of instrumental examinations. - Interpretation of the instrumental examinations findings at the most basic level. - Be able to interpret auscultation findings, imaging data; be competent in modern treatment options of heart diseases. - Be able to interpret auscultation findings, imaging data; be competent in modern diagnostic options of cardiomyopathy (nuclear magnetic resonance, genetic examinations, implantable rhythm recorders). - Be competent in the diagnosis of acute and chronic heart insufficiency, be able to interpret auscultation findings, imaging data, and be competent in modern diagnostic options and pathophysiological comprehension. - Be able to analyze situations, substantiate, logically formulate and explain their opinion. - evaluate blood test results, to attribute to certain clinical case and general examination data; - to evaluate urine test results, to attribute to certain clinical case and general examination data; - be able to assess cases, to argue, to make decision, to clarify opinion. | ||||||||
| Bibliography | |||||||||
| No. | Reference | ||||||||
| Required Reading | |||||||||
| 1 | Klīniskā Medicīna I daļa A.Lejnieka redakcijā. Sirds un Asinsvadu saslimšanas. Jānis Jirgensons, Oskars Kalējs. 2010. Nacionālais Apgāds | ||||||||
| 2 | Klīniskā Medicīna III daļa A.Lejnieka redakcijā. | ||||||||
| 3 | Sirds audzēji un sirds traumas. Oskars Kalējs, Ginta Kamzola, Milāna Zabunova. | ||||||||
| 4 | Laboratorijas diagnostika, kardioloģija. Oskars Kalējs, Aija Mača, Iveta Mintāle. 2012. Nacionālais Apgāds. | ||||||||
| 5 | Andrejs Kalvelis, Aivars Lejnieks. Dislipidēmiju novērtēšana un korekcija. Informatīvais materiāls. 2011. RSU. | ||||||||
| 6 | Andrejs Kalvelis. Klīniskā Elektrokardioloģija. 2008. Nacionālais apgāds. | ||||||||
| 7 | Andrejs Kalvelis. Elektrokardiogrāfija. 2010. | ||||||||
| 8 | Andrejs Kalvelis. Kardioloģijs. RSU 2010. | ||||||||
| 9 | Iekšķīgo slimību propedeitika. 3 izdevums RSU 2010. | ||||||||
| 10 | Iekšķīgo slimību propedeitika 4..izdevums RSU 2012. | ||||||||
| 11 | Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 9th edition. 2011. (Izd. Elservier Saunders). | ||||||||
| 12 | HARRISON`S Principles of Internal Medicine McGrawHill 2012. | ||||||||
| Additional Reading | |||||||||
| 1 | Rudzītis K. Diagnostikas pamati un terapijas preambula. Rīga: Zvaigzne, 1971; Rīga: Nacionālais apgāds, 2005. | ||||||||
| 2 | Kovša O. Iekšķīgās slimības. I un II daļa. Rīga: Zvaigzne, 1971. | ||||||||
| 3 | Latvijas Kardiologu biedrības Vadlīnijas – www.kardiologija.lv | ||||||||
| 4 | Eiropas Kardiologu biedrības Vadlīnijas – www.escardio.org | ||||||||
| 5 | Walter Siegenthaler. Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis. Thieme. 2007. | ||||||||
| 6 | Mintale, M.Zabunova, D.Lurina, I.Narbute, S.Jegere, I.Zakke, V.Dzerve, A.Erglis. The Role of Exercise Test after Percutaneous Coronary Intervention. Advances in Electrocardiograms. Clinical Applications. Edited by Richard Millis. Intech 2012. p.245-268 | ||||||||
| 7 | Mintāle I. Promocijas darbs medicīnas doktora grāda iegūšanai. LU Zinātniska bibliotēka. 2011 | ||||||||
| 8 | Douglas P.S. et al., ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. J Am Coll Cardiol, 2011; 57:1126-1166 | ||||||||
| 9 | Taylor A.J. et al. ACCF/SCCT/ACR/AHA/ASE/ASNC/NASCI/SCAI/SCMR 2010 Appropriate Use Criteria for Cardiac Computed Tomography J Am Coll Cardiol, 2010; 56:1864-1894. | ||||||||
| 10 | Hendel RC, Patel MR, Kramer CM, et al. ACCF/ACR/SCCT/SCMR/ASNC/NASCI/ SCAI/SIR 2006 Appropriateness Criteria for Cardiac Computed Tomography and Cardiac Magnetic Resonance Imaging. J Am Coll Cardiol 2006; 48: 1475–1497. | ||||||||
| 11 | Schroeder S, Achenbach S, Bengel F, et al. Cardiac computed tomography: indications, applications, limitations, and training requirements. Report of a Writing Group deployed by theWorking Group Nuclear Cardiology and Cardiac CT of the European Society of Cardiology and the European Council of Nuclear Cardiology. European Heart Journal 2008; 29: 531–556. | ||||||||
| 12 | Matthias G. Friedrich, Udo Sechtem, Jeanette Schulz-Menger, Godtfred Holmvang, Pauline Alakija, Leslie T. Cooper, James A. White, Hassan Abdel-Aty, Matthias Gutberlet, Sanjay Prasad, Anthony Aletras, Jean-Pierre Laissy, Ian Paterson, Neil G. Filipchuk, Andreas Kumar, Matthias Pauschinger, Peter Liu for the International Consensus Group on Cardiovascular Magnetic Resonance in Myocarditis | ||||||||
| 13 | Cardiovascular Magnetic Resonance in Myocarditis: A JACC White Paper. J. Am. Coll. Cardiol., April 28, 2009; 53: 1475 - 1487. | ||||||||
| 14 | McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, Falk V, Filippatos G, Fonseca C, Sanchez MAG, Jaarsma T, Køber L, Lip GYH, Maggioni AP, Parkhomenko A, Pieske BM, Popescu BA, Rønnevik PK, Rutten FH, Schwitter J, Seferovic P, Stepinska J, Trindade PT, Voors AA, Zannad F, Zeiher F. ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012. The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in Collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J doi:10.1093/eurheartj/ehs104 | ||||||||
| 15 | Mats Borjesson, Luis Serratosa, Francois Carre. Consensus Document Regarding Cardiovascular Safety at Sports Arenas Position Stand from the European Association of Cardiovascular Prevention and Rehabilitation (EACPR), Section of Sports Cardiology. Eur Heart J (2011) doi: 10.1093/eurheartj/ehr178 | ||||||||
| 16 | Bart S. Ferket, Tessa S.S. Genders, Ersen B. Colkesen, Jacob J. Visser, Sandra Spronk, Ewout W. Steyerberg, and M.G. Myriam Hunink. Systematic Review of Guidelines on Imaging of Asymptomatic Coronary Artery Disease. J. Am. Coll. Cardiol., April 12, 2011; 57: 1591 - 1600. | ||||||||
| 17 | Jānis Jirgensons, Oskars Kalējs. Bradiaritmijas un elektrokardiostimulācija. 2003. Nacionālais Apgāds. | ||||||||
| 18 | Zipes D, Sudden Cardiac Death; From Cells to Bedside. Elsevier Saunders 2009. | ||||||||
| 19 | Prystowsky E.N., Padanilam B.J., Joshi S., MD, Fogel R.I. Ventricular Arrhythmias in the Absence of Structural Heart Disease. J Am Coll Cardiol, 2012; 59:1733-1744. | ||||||||
| 20 | Gaganpreet K. Grewal, BS*, Tristan B. Klosterman, BS*, Kevin Shrestha, BS*, Hirad Yarmohammadi, MD*, Andrew O. Zurick, MD*, Brandon C. Varr, MD , W.H. Wilson Tang, MD*, Bruce D. Lindsay, MD*, Allan L. Klein, MD. Indications for TEE Before Cardioversion for Atrial Fibrillation: Implications for Appropriateness Criteria. J Am Coll Cardiol Img, 2012; 5:641-648 | ||||||||
| 21 | Zipes DP, Camm AJ, Borggrefe M, et al. ACC/AHA/ESC 2006 guidelines for management of patients with ventricular arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology/American Heart Association Task Force and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Develop Guidelines for Management of Patients With Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death) J Am Coll Cardiol 2006;48:e247-e346 | ||||||||
| 22 | Myerburg R.J., Juntiila M.J., Sudden Cardiac Death Caused by Coronary Heart Disease. Circulation. 2012; 125: 1043-1052 | ||||||||
| 23 | Expert – consult datu bāze Elsevier Saunders | ||||||||
| 24 | Datortomogrāfijas izmeklējumu kvalitātes kritēriji. www. radiologija.lv | ||||||||
| 25 | Robert J. Myerburg, Bernard R. Chaitman, Gordon A. Ewy, and Michael S. Lauer. Task Force 2: Training in Electrocardiography, Ambulatory Electrocardiography, and Exercise Testing. J. Am. Coll. Cardiol., January 22, 2008; 51: 348 - 354. | ||||||||
| 26 | R. H. Swanton. Cardiology Pocket Consultant. 5th edition. Wiley-Blackwell, 2003 | ||||||||
| 27 | Abrahams PH, Hutchings RT, Marks SC Jr. McMinn’s Colour Atlas of Human Anatomy. 4th edition. Elsevier Health Sciences, 2002 | ||||||||
| 28 | Harrison’s Manual of Medicine. 18th edition. McGraw-Hill Medical Publishing Division. 2012. | ||||||||
| Other Information Sources | |||||||||
| 1 | www.inbox.lv /ispropedeitika/ faili | ||||||||
| 2 | http://estudijas.rsu.lv/index.php | ||||||||
| 3 | www.escardio.org/guidelines | ||||||||
| 4 | www.circulationaha.org | ||||||||
| 5 | www.cardiosource.com | ||||||||
| 6 | www.theheart.org | ||||||||
| 7 | www.hrsonline.org | ||||||||
