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Internal Diseases (Cardiology)
Study Course Description
Course Description Statuss:Approved
Course Description Version:3.00
Study Course Accepted:26.01.2022 11:34:57
| Study Course Information | |||||||||
| Course Code: | ISK_217 | LQF level: | Level 7 | ||||||
| Credit Points: | 3.00 | ECTS: | 4.50 | ||||||
| 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: | Rga, 2 Hipokrāta Street, isk rsu[pnkts]lv, +371 67042338 | ||||||||
| Study Course Planning | |||||||||
| Full-Time - Semester No.1 | |||||||||
| Lectures (count) | 0 | Lecture Length (academic hours) | 0 | Total Contact Hours of Lectures | 0 | ||||
| Classes (count) | 10 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 30 | ||||
| Total Contact Hours | 30 | ||||||||
| Full-Time - Semester No.2 | |||||||||
| Lectures (count) | 0 | Lecture Length (academic hours) | 0 | Total Contact Hours of Lectures | 0 | ||||
| Classes (count) | 10 | Class Length (academic hours) | 3 | Total Contact Hours of Classes | 30 | ||||
| Total Contact Hours | 30 | ||||||||
| 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: | 1. Learn subjective and objective examination methods in practice – survey, examination, palpation, percussion and auscultation; interpret the obtained information in the context of cardiovascular diseases. 2. Train students how to interpret data gained from laboratory tests and instrumental examination, including modern examination methods in cardiology. 3. Learn the epidemiology of cardiovascular pathology, basic diagnostic principles and treatment methods. 4. Promote the development of student clinical thinking and decision-making. 5. Promote analytical and synthetic approaches to data interpretation of modern examinations (imaging diagnostics, invasive examinations and computer-assisted examination methods). | ||||||||
| Topic Layout (Full-Time) | |||||||||
| No. | Topic | Type of Implementation | Number | Venue | |||||
| 1 | Electrocardiography. Basic principles. Electrical axes of the heart, atrial and ventricular hypertrophies, propagation disorders in the atria and ventricles of the heart. | Classes | 1.00 | clinical base | |||||
| 2 | Signs of myocardial blood flow abnormalities on the ECG. The concept of myocardial damage. | Classes | 1.00 | clinical base | |||||
| 3 | Cardiac conduction system and its imaging in electrocardiography. Normal and pathological variants. | Classes | 1.00 | clinical base | |||||
| 4 | Clinical evaluation of heart disease. Common symptoms of heart disease, major congenital and acquired heart diseases, pathophysiology, diagnostics. | Classes | 1.00 | clinical base | |||||
| 5 | Cardiac evaluation by imaging (EHO kg, CT, MRI). ECG capabilities in early diagnosis of heart disease. Treatment methods for heart valve disease and congenital heart disease (surgical and minimally invasive valve prosthesis, valve surgery, defect closure, etc.). Topic summary. | Classes | 1.00 | METC | |||||
| 6 | Cardiomyopathies. Classification of cardiomyopathies. Principles of diagnostics. Unclassified cardiomyopathies. Pathophysiological features. | Classes | 1.00 | clinical base | |||||
| 7 | Arterial hypertension. Primary and secondary hypertension. Clinical evaluation – risk factors, target organ damage, complications. | Classes | 1.00 | clinical base | |||||
| 8 | Arterial hypertension: treatment – principles of non-pharmacological therapy and pharmacotherapy. The choice of pharmacotherapy. | Classes | 1.00 | clinical base | |||||
| 9 | Hypertension and risk of complication. Hypertensive crysis. Pseudoresistant hypertension. Secondary hypertension. Treatments. Summary of topic. | Classes | 1.00 | clinical base | |||||
| 10 | Chronic heart failure: Pathophysiological mechanisms, ABCD and NYHA classifications, risks, clinical, laboratory (BNP) systolic and diastolic function, EhoKG and ECG assessment. | Classes | 1.00 | clinical base | |||||
| 11 | Coronary heart disease. Causes, epidemiology, risk factors, pathophysiological mechanisms. Chronic coronary syndrome: Angina, its types. Diagnosis, classification, examination and treatment. | Classes | 1.00 | clinical base | |||||
| 12 | Acute coronary syndrome, possibilities of its development. Myocardial infarction, its classification, mechanisms, types of infarction. Modern tactics in case of acute coronary syndrome (student should be able to understand and act in various situations, solve situation tasks, justify the necessity and role of diagnostic findings). Complications of myocardial infarction. Risk after myocardial infarction, risk assessment, methods, significance. | Classes | 1.00 | METC | |||||
| 13 | Treatment strategy for CHD: conservative and/or invasive (PCI, bypass, hybrid procedures). Topic summary. | Classes | 1.00 | clinical base | |||||
| 14 | Chronic and acute heart failure. Princoples. Pathophysiology. Mechanisms. | Classes | 1.00 | clinical base | |||||
| 15 | Acute heart failure: pathophysiological mechanisms, clinical evaluation of major clinical types (pulmonary oedema, cardiogenic shock). Additional examinations (central venous pressure, pulmonary capillary entrapment pressure, etc.). Treatment of chronic heart failure: non-pharmacological and pharmacological. Treatment of acute heart failure. Topic summary. | Classes | 1.00 | METC | |||||
| 16 | Arrhythmias I. Supraventricular tachyarrhythmias. Pharmacological and non-pharmacological treatment. Arrhythmias II. Ventricular arrhythmias. Inherited arrhythmias. Pharmacological and non-pharmacological treatment. | Classes | 1.00 | METC | |||||
| 17 | Arrhythmias II. Ventricular arrhythmias. Inherited arrhythmias. Pharmacological and non-pharmacological treatment. Risk identification and prevention | Classes | 1.00 | clinical base | |||||
| 18 | Arrhythmias III. Atrial fibrillation and atrial flutter. Reasons, classification, clinic. Arrhythmias: conduction disorders, clinical and ECG assessment. Pharmacological and non-pharmacological treatment. Prevention of thromboembolic events. Topic summary. | Classes | 1.00 | clinical base | |||||
| 19 | Primary cardiomyopathies. Life treatening cardiomyopathies. Secundary cardiomyopathies. Typical pathophysiological mechanisms. Nuances of treatment. Prevention. Sudden Cardiac Death. | Classes | 1.00 | clinical base | |||||
| 20 | Concept of thrombosis. Thromboses of the venous system. Pulmonary artery thromboembolism. Pulmonary hypertension. Practical test: disease history. | 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 the existing learning material. | ||||||||
| Assessment Criteria: | A test consisting of 3 parts: • clinical situations with examination results – 35%; • multiple choice questions (OSCE) – 30% of the total mark; • examination results and their interpretation (Electrocardiography, echocardiography, coronarography, MRI/description) – 35%. | ||||||||
| Final Examination (Full-Time): | Exam | ||||||||
| Final Examination (Part-Time): | |||||||||
| Learning Outcomes | |||||||||
| Knowledge: | Demonstrate orientation in the newest medical technologies, examination methods and 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 the possible level of pathology. • Analyse the obtained information to evaluate the pathological degree and the corresponding risks. • Be competent in pathological processes under consideration and be able to analyse those aspects of pathophysiology. | ||||||||
| Skills: | • Be able to communicate with patients, their relatives, colleagues, other people or organizations involved in health care. • Obtain information about the patient's complaints and anamnesis; • Perform physical examination of the patient with palpation, percussion and auscultation methods and methods derived from those. • Take the peripheral pulse, heart rate, respiratory rate and arterial pressure indicators, relate them to a particular clinical situation and link it with the overall examination process. • Be competent in ECG results. • Be competent in the results of instrumental examination 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 and imaging data. • Have a grasp of the diagnosis of coronary heart disease and early recognition and treatment tactics of various acute situations. • 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, 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, able to interpret auscultation findings, imaging data, and be competent in modern diagnostic options and pathophysiological comprehension. • Able to summarize the acquired symptoms and present the diagnosis and medical history. | ||||||||
| Competencies: | • Evaluate the acquired symptoms, linking them with pathological processes in the patient's body. • Interpret basic imaging (echocardiography, CT, MRI) data. • Explain the necessity of instrumental examinations. • Interpret the findings of instrumental examinations at the most basic level. • Able to interpret auscultation findings, imaging data; be competent in modern treatment options of heart diseases. • 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 failure, be able to interpret auscultation findings, imaging data, and be competent in modern diagnostic options and pathophysiological comprehension. • Able to analyse situations, substantiate, logically formulate and explain their opinion. | ||||||||
| Clinical Skills: | |||||||||
| No. | Skill | Level | |||||||
| 1 | Anterior and lateral comparative percussion of lungs | A - Beginner level | |||||||
| 2 | Apex beat mobility test | A - Beginner level | |||||||
| 3 | Auscultation of lungs | A - Beginner level | |||||||
| 4 | Heart auscultation (topographic order) | A - Beginner level | |||||||
| 5 | Heart auscultation (traditional) | A - Beginner level | |||||||
| 6 | Liver percussion | A - Beginner level | |||||||
| 7 | Measurement of arterial pulse | A - Beginner level | |||||||
| 8 | Measurement of the arterial pressure | A - Beginner level | |||||||
| 9 | Measurement of the radial pulse tension | A - Beginner level | |||||||
| 10 | Palpation of apex beat | A - Beginner level | |||||||
| 11 | Palpation of spleen | A - Beginner level | |||||||
| 12 | Palpation of the liver | A - Beginner level | |||||||
| 13 | Posterior lungs comparative percussion | A - Beginner level | |||||||
| 14 | Topographic percussion of the lung's inferior edge | A - Beginner level | |||||||
| Bibliography | |||||||||
| No. | Reference | ||||||||
| Required Reading | |||||||||
| 1 | Klīniskā Medicīna, I., II., III. daļa. A. Lejnieka redakcijā, 2010.-2012. Nacionālais Apgāds (akceptējams izdevums) | ||||||||
| 2 | Kalvelis, Andrejs. Klīniskā Elektrokardioloģija. 2008. Nacionālais Apgāds. (akceptējams izdevums) | ||||||||
| 3 | Braunwald's Heart Disease. A Textbook of Cardiovascular Medicine. 12th edition. 2022. Elsevier and following edt. | ||||||||
| 4 | Harrisson's Principles of Internal Medicine 20th edition. (Vol.1 & Vol.2.). McGrawHill, 2021 | ||||||||
| 5 | Hampton, John. ECG Made Practical. 7th edition, Kindle Edition. 2019 | ||||||||
| 6 | Guidelines of international professional associations in the diagnosis and treatment of cardiovascular diseases | ||||||||
| 7 | Praktiskie Materiāli Kardioloģijas kursam | ||||||||
| 8 | Practical Materials for Cardiology course | ||||||||
| 9 | Ārvalstu studentiem/For international students: | ||||||||
| 10 | Braunwald's Heart Disease. A Textbook of Cardiovascular Medicine. 12th edition. 2022. Elsevier and following edt. | ||||||||
| 11 | Harrisson's Principles of Internal Medicine 20th edition. (Vol.1 & Vol.2.). McGrawHill, 2021 | ||||||||
| 12 | Hampton, John. ECG Made Practical. 7th edition, Kindle Edition. 2019 | ||||||||
| Additional Reading | |||||||||
| 1 | Siegenthaler, Walter. Differential Diagnosis in Internal Medicine: From Symptom to Diagnosis Hardcover, 2007 | ||||||||
| 2 | Siegenthaler, Walter. Siegenthalers Differenzialdiagnose: Innere Krankheiten - vom Symptom zur Diagnose. 2013 | ||||||||
| 3 | Goldberger, Ari L. Clinical Electrocardiography E-Book (Clinical Electrocardiography: A Simplified Approach). 8th edition, Kindle Edition, 2018 | ||||||||
| 4 | Surawicz, B., Knilans, T. Chou's Electrocardiography in Clinical Practice E-Book: Adult and Pediatric. 6th edition, Kindle Edition. | ||||||||
| 5 | Douglas, P., William, G., et al. Zipes and Jalife's Cardiac Electrophysiology: From Cell to Bedside. 11th edition, 2022 | ||||||||
| 6 | Armstrong, William F., Thomas, R. Feigenbaum's Echocardiography (Englisch) Gebundenes Buch – 30. Oktober 2018 | ||||||||
| 7 | Catherine M., et.al. Textbook of Clinical Echocardiography (Englisch) Gebundenes Buch – 28. Februar 2018 | ||||||||
| 8 | Flachskampf, Frank Arnold. Kursbuch Echokardiografie: Unter Berücksichtigung nationaler und internationaler Leitlinien Gebundenes Buch. 2022 | ||||||||
| 9 | Antonio Pelliccia The ESC Textbook of Sports Cardiology. 2019 | ||||||||
| Other Information Sources | |||||||||
| 1 | www.hrsonline.org | ||||||||
| 2 | www.cardiosource.com | ||||||||
| 3 | www.kardiologija.lv | ||||||||
| 4 | e-studijas | ||||||||
| 5 | radiologija.lv | ||||||||
| 6 | Ārvalstu studentiem/For International students: | ||||||||
| 7 | www.cardiosource.com | ||||||||
| 8 | www.hrsonline.org | ||||||||
