Cardiology

Royal College Competencies

• 2.1.2. Cardiac disease
  • 2.1.2.1. Chest pain
  • 2.1.2.2. Dyspnea
  • 2.1.2.3. Syncope
  • 2.1.2.4. Palpitations
  • 2.1.2.5. Cardiac murmurs
  • 2.1.2.6. Abnormal cardiac enzymes
  • 2.1.2.7. Congestive heart failure
  • 2.1.2.8. Coronary heart disease
  • 2.1.2.9. Acute coronary syndromes and their complications
  • 2.1.2.10. Valvular heart disease
  • 2.1.2.11. Cardiomyopathies
  • 2.1.2.12. Pericarditis and pericardial effusion and tamponade
  • 2.1.2.13. Pulmonary hypertension
• 2.1.3. Vascular disease
  • 2.1.3.1. Hypertension
  • 2.1.3.2. Claudication
  • 2.1.3.3. Edema
  • 2.1.3.4. Aortic aneurysm
  • 2.1.3.5. Venous thrombo-embolic disease and prophylaxis
  • 2.1.3.6. Peripheral arterial disease
  • 2.1.3.7. Peripheral venous insufficiency
  • 2.1.3.8. Venous and arterial ulcers

Introduction

• 1 in 3 will have CV disease.
• Coronary Artery Disease (CAD)
  • Men: 2 in 3 (67%)
  • Women: 1 in 2 (50%)
• INTERHEART Study
  • INTERHEART Study assessed risk factors for CVD globally (included 30,000 pts) in 52 countries.
  • Showed differences in risk of CVD
    • South Asians have highest risk. (more central obesity, insulin resistance etc..)
  • Waist circumference or waist-to-hip ratio indicators of abdominal obesity predict CVD independent of BMI.
    • Being an "apple" fat in abomen is worse than being a "pear" fat in hips.
• Mortality in heart disease is much higher than chronic kidney disease (CKD).
  • Any degree of albuminuria is an independent risk factor for CV events, heart failure hospitalizations and all-cause mortality.

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