Veidlapa Nr. M-3 (8)
Study Course Description

Emergency Cardiology and Intensive Therapy I

Main Study Course Information

Course Code
RKA_030
Branch of Science
Clinical medicine
ECTS
11.00
Target Audience
Medicine
LQF
Level 8

Study Course Implementer

Course Supervisor

Residency Speciality

Speciality
Supervisor of Medical Speciality
Contacts

-

About Study Course

Objective

The course is designed for cardiology residents to acquire theoretical and practical knowledge as well as practical skills about acute cardiovascular pathologies, including intensive therapy (etiology, pathology, clinical symptoms, diagnostics, differential diagnoses, treatment methods, emergency care, monitoring of acute and hemodynamically unstable patients, early and late rehabilitation).

Learning Outcomes

Knowledge

1.- In-depth knowledge of acute cardiac pathology (etiology, pathogenesis, clinical picture, investigation methods, differential diagnoses, treatment options, early rehabilitation); - Detailed insight into possible indications, contraindications, complications using invasive and non-invasive treatment options; - Pharmacology, indications, contraindications for therapy used in acute cardiac patients, incl. for maintenance of hemodynamics, prevention and therapy of thrombosis; - Knowledge of the state of the respiratory system in a patient with acute cardiac pathology (interpretation of arterial and venous blood gas tests; principles of acute respiratory insufficiency therapy; principles of oxygen therapy selection, including indications, selection and provision of various invasive and non-invasive mechanical ventilation methods); - Principles of fluid, electrolyte, acid-base and kidney support (principles of renal failure management, including general knowledge of renal replacement therapy (hemofiltration and dialysis); - Maintenance of general metabolism (nutritional balance, assessment and management of basic metabolic function requirements); - Principles of diagnosis, treatment, prevention of cardiac and generalized infections (interpretation of microbiological sampling and microbiological test results; selection of basic antimicrobial agents, indications, complications, interactions and monitoring).

Skills

1.- formulate the primary diagnosis for acute cardiovascular pathologies, based on clinical and physical examination and additional examination data; - diagnose the three main pathogenic mechanisms of cardiac arrest (VF/VT, asystole and pulseless electrical activity [electromechanical dissociation]) and provide first aid according to the algorithms defined in the guidelines; - perform short-term intravenous general anesthesia for emergency, urgent and planned treatment of rhythm disorders with electroimpulse therapy, be able to choose and perform appropriate therapy for rhythm disorders; - perform CPR according to basic and advanced algorithms, as well as continue patient care after cardiocerebral resuscitation measures; - according to the indications, perform indirect heart massage, electrodefibrillation, tracheal intubation, use MPV by choosing appropriate respirators, MPV regimes, intracardiac medication administration; - to know the indications of plasmapheresis; - must be able to diagnose and treat post cardiac arrest syndrome (including therapeutic hypothermia); - perform puncture and catheterization of central and peripheral blood vessels, determine and interpret vital functions and hemodynamic indicators, as well as apply the most modern treatment methods to ensure vital functions; - specific medication administration and dosing methodology – intravenous administration of medication using drip infusion, perfusors and other instruments (skill to practically prepare instruments, perform central venous and peripheral vascular catheterization, knowledge of highly effective substances (dopamine, dobutamine, sodium nitroprusside, nitroglycerin, lidocaine etc.) for indications for use, dosage, side effects). - perform screening EchoKg, aortic balloon counterpulsation, interpret 12-lead ECG; - perform pericardiocentesis in case of cardiac tamponade.

Competences

1.- independently draw up an examination plan and perform differential diagnosis for a patient with suspected acute cardiac pathology, - provide cardiological emergency medical assistance, intensive therapy and resuscitation measures, including cardiopulmonary resuscitation; - the ability to care for a patient with an acute cardiological profile in intensive therapy, including the ability to monitor and ensure the vital functions of hemodynamically unstable patients.

Assessment

Individual work

Title
% from total grade
Grade
1.

Individual work

-
-
The prepared presentation on the topics mentioned in the course description, researches the topic in depth, within the framework of his research work, familiarizes himself with the required literature, engages in pedagogical work (training of students and junior residents).

Examination

Title
% from total grade
Grade
1.

Examination

-
-
Mandatory (100%) performance of practical work. Overdue work must be completed. Attendance of seminars and lectures (at least 75%) on the subject of the course. Form of course examination: oral examination in the form of discussions.

Study Course Theme Plan

FULL-TIME
Part 1
  1. Seminar

Modality
Location
-
-

Topics

KSS. Acute coronary syndrome (myocardial infarction) with ST elevations. Diagnostics, investigation and logistics.
  1. Seminar

Modality
Location
-
-

Topics

2. KSS. Acute coronary syndrome (myocardial infarction) with ST elevations. Pharmacotherapy and invasive treatment.
  1. Seminar

Modality
Location
-
-

Topics

KSS. Acute coronary syndrome without ST elevations. Diagnostics, investigation, risk stratification and logistics.
  1. Seminar

Modality
Location
-
-

Topics

KSS. Acute coronary syndrome without ST elevations. Pharmacotherapy and invasive treatment.
  1. Seminar

Modality
Location
-
-

Topics

Complications of myocardial infarction.
  1. Seminar

Modality
Location
-
-

Topics

Cardiogenic shock. Hypotension.
  1. Seminar

Modality
Location
-
-

Topics

Pulmonary edema and cardiac asthma.
  1. Seminar

Modality
Location
-
-

Topics

Cardiopulmonary resuscitation. Cardiocerebral resuscitation. Therapeutic hypothermia.
Total ECTS (Creditpoints):
11.00
Number of Residency Seminars:
8
Length (weeks):
8
Final Examination:
Residency exam (Theory and practice)

Bibliography

Required Reading

1.

Eiropas kardiologu biedrības vadlīnijas. Pieejams: http://www.escardio.org, http://www.escardio.org/guidelines-surveys/esc-guidelines/Pages/GuidelinesList.aspx

2.

Amerikas Sirds asociācijas un Amerikas Kardioloģijas koledžas vadlīnijas un zinātniskie paziņojumi. Pieejams: http://www.ahajournals.org/misc/sci-stmts_topindex.shtml

3.

Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 10th Edition. Copyright © 2015, 2012, 2008, 2005, 2001, 1997, 1992, 1988, 1984, 1980 by Saunders, an imprint of Elsevier Inc.

4.

ERC Guidelines for resuscitation 2015. Pieejams: http://ercguidelines.elsevierresource.com

5.

Kaplan's Cardiac Anesthesia, 7th Edition. Copyright © 2017 by Elsevier, Inc. All rights reserved.

Additional Reading

1.

Acute Cardiovascular Care Textbooks. ESC Textbook of Intensive and Acute Cardiovascular Care. 2nd Edition, second online update 2017.

2.

Acute Coronary Syndromes: A Companion to Braunwald's Heart Disease, 2nd Edition, Copyright © 2011, 2003 by Saunders, an imprint of Elsevier Inc.

3.

Cardiovascular Therapeutics: A Companion to Braunwald's Heart Disease, 4th Edition. Copyright © 2013, 2007, 2002, 1996 by Saunders, an imprint of Elsevier Inc.

4.

Cardiology Secrets, 5th Edition. Copyright © 2018 by Elsevier, Inc. All rights reserved.

5.

R. D.Miller “Miller’s Anaesthesia”, vol. I, II, 8th Edition., Elsevier, 2015.

Other Information Sources

1.

ClinicalKey. Pieejams: https://www.clinicalkey.com

2.

UpToDate. Pieejams: https://www.uptodate.com

3.

ScienceDirect. Available from: https://www.sciencedirect.com

4.

Knowledge centre of the European Society of Cardiology. Pieejams: http://www.escardio.org/knowledge

5.

Eiropas Kardiologu biedrības žurnāli: European Heart Journal, Heart Failure, Cardiovascular Prevention and Rehabilitation, EP Europace, Echocardiography. Pieejams: http://www.escardio.org/Pages/index.aspx

6.

Amerikas Sirds asociācijas žurnāli: Circulation, Circulation: Arrhythmia and Electrophysiology, Circulation: Heart Failure, Circulation: Cardiovascular Imaging, Circulation: Cardiovascular Interventions, Circulation: Cardiovascular Quality and Outcomes, Circulation: Cardiovascular Genetics: http://www.ahajournals.org/circportfolio/; Hypertension, Stroke, Arteriosclerosis, Thrombosis, and Vascular Biology. Available from: http://www.ahajournals.org/.

7.

Journal of the American College of Cardiology. Pieejams: http://www.onlinejacc.org

8.

New England Journal of Medicine. Pieejams: http://content.nejm.org

9.

Journal of American Medical Association. Pieejams: http://jama.ama-assn.org

10.

The Lancet. Pieejams: http://www.thelancet.com

11.

British Medical Journal. Pieejams: http://www.bmj.com

12.

Latvijas ārsts

13.

Doctus

14.

Medicus Bonus