UNIVERSITAS PEMBANGUNAN NASIONAL "VETERAN"

JAKARTA
FAKULTAS KEDOKTERAN UMUM COURSE STUDY GUIDE (CSG)
CARDIOVASCULAR SYSTEM

RESOURCE
LEARNING OBJECTIVES REFERENCES
PERSON
TOPIC SUB TOPIC

BASIC SCIENCE OF EMBRYOLOGY At the end of the chapter, the learner will be able to explain :
CARDIOVASCULAR NORMAL EMBRYOLOGY 1. Formation of the heart tube
SYSTEM 2. Formation of the heart loop
. Truncus arteriosus, bulbus/conus cordis, ventricle, atrium, sinus
venosus
3. Formation of cardiac septum:
. Septum in the atrium-septum primum-septum
secundum, septum in the ventricle, septum in the truncus and
conus, septum in the atrioventricular canal
4. Formation of the valves: bicupid, tricuspid, semilunar valves

5. ASD: Atrial Septal Defect:

EMBRYOLOGY OF CONGENITAL HEART DISEASE
. Ostium secundum defect, septum primum resorption, inadequate
development of the septum secundum
6. VSD: Ventricular Septal Defect:
. Partition of truncoconal region, muscular dafect of the septum,
mebranous defect
7. Transposition of the vessels:
. Abnormal truncoconal septum function, defect in membranous part
of inetrventricular septum
8. Patent Ductus Arteriosus:
. Valvular stenosis, valvular atresia, closure of ductus arteriosus
9. Tetralogy Fallot:
. Pulmonary stenosis interrventricular septa defect, hyperthrophy of
the ventricular wall, overriding of the ventricular septum

CARDIOVASCULAR ANATOMY 10. ASD:Atrial Septal Defect:

. Ostium secundum defect, septum primum resorption, inadequate
development of the septum secundum
11. VSD: Ventricular Septal Defect:
. Partition of truncoconal region, muscular defect of the septum,
membranous defect
12. Transpotition of the vessels:
. Abnormal of truncoconal septum functio, defect in membranous
part of interventricular septum
13. Patent Ductus Arteriosus:
. Valvular stenosis, navular atresia, closuere of ductus arteriosus
14. Pulmonary stenosis, interventricular septal defect, hiperthroophy of
the ventricular wall, overriding of the ventricular septum

CARDIOVASCULAR PHYSIOLOGY
15. At the end of the chapter, the learner will be able to rxplain the
pricipies of cardiovascular physiology (C3)
. Illustrate the physilogical characteristic of the heart sa a pump
* explain the physilogy of the heart muscle
* explain the cardiac cycle
* explain the regulation of heart pump
. Explain the mechanism of rhythmical excitation of the heart
* explain the specialized excitatory and conductive system of the
heart
* explain the control of excitation and conduction in the heart
. Sketch the normal ECG Characteristic of the normal Electro Cardio
Grams.
* explain the nethod for recording electrocardiograms.
* explain the flow of current around the heart during the cardiac
cycle.
* explain the electrocardiographic leads.
 . Explain the medical physics of pressure, flow, and resistence
* explain the physical characteristics of the circulation.
* explain the basic theory of the circulation finction.
* explain the interrelationship among pressure, flow, and
resistance.
. Explain the function of the arterial and venous system
* explain the vascular distensibility.
* explain the arterial pressure pulsation.
* explain the veins and their functions
. Explain the micro circulation and lymphatic system.
* explain the structure of the microcirculation and capillary
system
* explain the flow of blood in the capillaries
* explain the exchange of nutrient and other subtance between
the blood and interstitial fluid.
* explain the interstitium and interstitial fluid.
* explain the importance of protein in the plasma and interstitial
fluid are especilly in controling plasma and interstitial fluid
volume
* explain the lymphatic system.
. Explain the mechanism of circulation control
* explain the local control of blood flow in response to tissue
needs
* explain the mechanism of blood flow control.
* explain the mechanism of humorals regulartion of the circulation.
* explain the mechanism of nervous regulation of the circulation.
* explain the role of the nervous system for rapid control of
arterial pressure
* explain thespecial feature of nervous control of arterial
pressure
* explain the function of the renal body fluid system for arterial
perssure explain the effect of the renninangiotensin system
. Illustrate the cardiac output, venous return
* explain the normal value for cardiac output at rest and during
activity
* explain the control of cardiac output by venous return-role of
the Frank-Starling mechanism of the heart.
* explain what are the pathologically high and pathologically low
cardisc output
* explain the quantitative analysis of cardiac output regulation
* explain the method of measuring cardiac output
. Explain the muscle blood flow and coronary circulation
* explain about the blood flow in skeletal muscle an its regulation
during exercise
* explain about the coronary circulation
. Explain yhe heart sound
* explain about the heart sounds and their relationship with valve
functions
* explain the dynamics of the circulation in cardiac failure
CONGENITAL * explain about the unilateral left heart failure
HEART DISEASE * explain what is low-output cardiac failure-cardiogenic shock
* explain the mechanism of edema in patient with cardiac failure
* explain what is the cardiac reserve
* illustrate the physiologic causes of shock
* give some example types of shock

PREVALENCE OF CONGENITAL HEART DISEASE 16. At the end of the chapter, the learner will be able to describe the
prevalence of congenitalheart disease (C3)

FETAL AND PRENATAL CIRCULATION 17. At the end chapter, the learnerwill be able to explain the fetal
and prenatal circulation (C3)

PATHOPHYSIOLOGY 18. patophysiology of left to right shunt lesion (C3)

19. patophysiology of cyanotic congenital heart disease (C3)

PATHOLOGY OF THE HEART 20. At the end of the chapter, the learner will be able to describe :
(VSD,ASD,PDA.TETRALOGY OF pathology of the heart (VSD, ASD,PDA, Tetralogy of Fallot )(C3)
FALLOT) 21. the situs (C2)

SPECIFIC CONGENITAL HEART DISEASE

LEFT TO RIGHT SHUNT:

NOMENCLATURE OF CONGENITAL HEART A.ATRIAL SEPTAL DEFECT (ASD)
DISEASE

B.Ventricural Septal Defect
( VSD)
c. Persisitent Ductus
Arteriousus (PDA)
Cyanotyc Congenetal Heart
Disease:
Tetralogy of Fallot (TF)
22. AV-VA concordance (C2)
23.to categorize the left to right shunt lesions
At the end of the chapter, the learner will be able to:
24. state the definition of ASD (C1)
25. Explain symptoms & signs
Clinical findings ( symptoms )
Physical findings ( C2 )
Radiological finding ( C3 )
Blood, ECG & echochardigraphy findings ( C2 )
Catherization & Angiocardigraphy finding ( C1 )
26. Examine the natural history of ( C4 )
Heart Faiilure ( C3 )
Eisenmenger/pulmonaryvasculardisease(C3)
Endocarditis(C3)
Pulmonary hypention (C 3)
27. explain the management (C2)
The general management (C4)
Management of associated condition (C2)
Management of complications (C2)
28 explain the prognosis (C4)
At the the capter, the learner will be able to:
29. state definition of VSD (C1)
30. explain the symptoms & signs
Clinical findings (symptoms)
Physical findings (C2)
radiological findings (C3)
blood,ECG & angio cardiography findings (C1)
31. examine the natural history (C4)
heart failure (C3)
Einsenmenger/Pulmonary Vascular disease (C3)
Pulmonaryhypertantion(C3)
32. explain the management (C2)
The general management (C4)
Managemet of associated conditions (C2)
Management of complications (C4)
Timing of sugery (C2)
33. explainthe prognosis (C4)
At the endof the chapter, the learner will be able to :
34. state definition of PDA (C1)
35. explain the symptoms & signs
Clinical findings (symptoms)
Physical findings (C2)
Radiological findings (C3)
Blood, ECG & echocardiography findings (C2)
Catheterization & angiocardiography findings (C1)
36. examine the natural history (C4)
Heart failure (C3)
Einsenmenger/pulmunary Vascular disease (C3)
Endocarditis (C3)
Pulmonary hypertension (C3)
37. explain the management (C2)
The general managemet (C4)
Management of associated conditions (C2)
Managements of complications (C4)
Timing of sugery (C2)
38. explain the prognosis (C4)
At the end ofbteh chapter, the learner will be able to:
39. state the definition of TF
40. expain the clinical presentation and findings in TF
Definition and the cause fo cianosys (C2)
Pathophysiology of cianosis (C2)
 41. expalain the methemoglobinemia, the causes of genetic and acquired Methemoglobinemia (C2)
42. explain thesymptoms & sign
Theclinicalfindings(symptoms)
Physical findings (C2)
Radiologal findings (C3)
Blood, ECG & echocardioghraphy findings (C2)
Catheterization & angiocardiography findings (C1)
43. examine the natural history (C4)
The Hypoxic spell (C3)
The cardiac arrest and respiratory failure. (C3)
The brain abscess (C3)
The cardiovascular accident (C3)
The rndocarditis (C3)
The polycithemia (C3)
The relative iron deficiency (C3)
The endocarditis (C3)
INFECTIVE 44. explain the management
ENDOCARDITIS . explain the general management (C4)
. management of associated condition (C2)
. the condition of complication (C4)
. performing cardiopulmonary resuscitation timing of surgery (C2)
45. explain the prtognosis

At the end of the Chapter , The learner will be able to :

Congenital heart disease in Adult 46. State the definition of cogengital heart disease in adult (C1)
47. Explain clinical presentation & findings
Symptoms & sign
Physical findings( C2 )
Radiological findings ( C3 )
Lab Examination , ECG & Echocardiography findings ( C1 )
Catheterization & Angiochardiography findings (C1 )
48. Examine the natural history ( C4 )
49. Explain the complication ( C3 )
Rheumatic Disease
50. Explain The management ( C3 )
51. Exlain The prognesis ( C4 )

At the end of the chapter, the learner will be able to :

Prevalence 52. describe the prevelance of IE ( C3 )
Pathogenesis 53. Explain the Ethiology and Patogenesis of IE ( C3 )
Pathology 54 Explain the pathology of IE ( C3 )
Microbiology 55. Understand the microbiology of IE ( C3 )
Clinical Aspect 56. Explain the definition of IE ( C1 )
57 Explain the physical findings ( C3 )
. History
. Physical Examination
Diagnosis 58. Describe the lab and diagnostic tool findings: lab
Examination, ECG, and Echocardiography.
59.Interpret chest roentgenogram of IE ( C3 )
60. Analize and makea Diagnose of IE ( C4 )
Prognosis 61. Explain the prognosis of IE ( C4 )
Management 62. Explain the principles of management of IE ( C4 )
Prevention 63. Explain the preventation of IE ( C4 )

Acute rheumatic fever
At the end of the chapter, the learner will be able to :
64. Describe the epidemyoiogy of streptococcus infections and rheumatic fever ( C2 )
65. Describe the prevaient theories of ways how streptococcal infection causes rheumatic fever ( C2 )
66. Deecribe the pathologyof rheumatic fever ( C2 )
67. Describe extracardiac pathology ( C2 )
68. Categorize the clinical manifestations major criteria by examining :
The carditis ( C4 )
The Arthritis ( C4 )
The Corea ( C4 )
The Erythema marginatum ( C4 )
The Subcutaneous nodule ( C4 )
69. Categorize the clinical manifestations major criteria by examining :
The arthralgia ( C4 )
The fever ( C4 )
The acute phase reactants ( C4 )
VALVULAR HEART DISEASE

Recurrences of rheumatic fever
70 Describe laboratory findings : ASTO, CRP
71. Categorize the diagnosis and differential diagnosis( C4 )
72. Explain the treatment ofacute rheumatic fever ( C4 )
Treatment of Chorea ( C4 )
Treatment of heart failure ( C4 )
73. Describe the role of steroids (prednisone) used in treatment in rheumatic fever ( C4 )
74. Describe prophylaxis :
The primary prophylaxis ( C4 )
The secondary prophylaxis ( C4 )
75. Solve the prognosis ( C4 )
76. Describe the recurrences of rheumatic fever ( C2 )

Mitral Valve Disease 77. At the end of the chapter, the learner will be able to :
A. Mitral Stenosis Sumarize the natural history, etiology, pathology, and pathophisiology ( C2 )
Describe the history ( C2 )
Explain the physical Examination ( C3 )
Describe the ECG, Echocardiography, and Angiography ( C2 )
Interpret the radiological findings ( C3 )
Explain the medical treatment ( C4 )
Describe the valvotom ( bailon mitral valvuplasty ) and surgical ( C2 )
B. Mitral Regurgitation 78. At the end of the chapter, the learner will be able to :
Cronic Mitral regurgigation Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Explain the physical Examination ( C3 )
Describe the ECG, Echocardiography, radio nucide angiography, MRI, and Left ventricular angiography ( C2 )
Interpret the radiological findings ( C3 )
Explain the medical treatment ( C4 )
Describe the surgical treatment ( C 2 )
Acute Mitral regurgigation 79. At the end of the chapter, the learner will be able to :
Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Explain the physical Examination ( C3 )
Describe the ECG, Echocardiography, radio nucide angiography, MRI, and Left ventricular angiography ( C2 )
Interpret the radiological findings ( C3 )
Explain the medical treatment ( C4 )
Describe the surgical treatment ( C 2 )
Mitral valve prolaps syndrome 80. At the end of the chapter, the learner will be able to :
Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Explain the physical Examination ( C3 )
Describe the ECG, Echocardiography, angiography ( C2 )
The diagnoistic criteria (mayor & minor criteria ) (C1)
Explain the management ( C4 )
Aortic valve disease 81. At the end of the chapter, the learner will be able to :
A. Aortic Stenosis Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Explain the physical Examination ( C3 )
Describe the ECG, Echocardiography, radio nucide angiography, MRI, and Left ventricular angiography ( C2 )
Inte
rpret the radiological findings ( C3 )
Explain the medical treatment ( C4 )
B. Aortic Regurgigation Describe the surgical treatment ( C 2 )
Chronic Aortic Regurgigation 82. . At the end of the chapter, the learner will be able to :
Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Explain the physical Examination ( C3 )
Describe the ECG, Echocardiography, radio nucide angiography, MRI, and Left ventricular angiography ( C2 )
Interpret the radiological findings ( C3 )
Explain the medical treatment ( C4 )
AcuteAorticRegurgigation Describe the surgical treatment ( C 2 )
83. At the end of the chapter, the learner will be able to :
Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Explain the physical Examination ( C3 )
Describe the ECG, echocardiography ( C2 )
Interpret the radiological findings ( C3 )
Explain the medical treatment ( C4 )
Tricuspid valve disease Describe the surgical treatment ( C 2 )
84. At the end of the chapter, the learner will be able to :

A. Tricuspid Stenosis
B. Tricuspid regurgigation
 Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Explain the physical Examination ( C3 )
Describe the ECG, echocardiography ( C2 )
Interpret the radiological findings ( C3 )
Explain the medical treatment ( C4 )
PULMONARY VALVE DISEASE
Describe the surgical treatment ( C 2 )
A. PULMONARY STENOSIS
85. At the end of the chapter, the learner will be able to :
Summarize the natural history, etiology, pathology, and pathophsycology ( C2 )
Describe the history (C2 )
Eplain the physical examination (C3)
Describe the ECG, echocardiography (C2 )
Interpret the radiological findings ( C3 )
Explain the management ( C4 )
B. PULMONIC REGURGITATION
86. At the end of the chapter, the learner will be able to :
Summarize the etiology, pathology and pathophysiology (C2)
Describe the history (C2)
Explain the physical examination (C3)
Describe the ECG, echocardiography (C2)
Interpret the radiological findings (C3)
MULTIVALVULAR DISEASE
Explain the management (c4)

87. At the end of the chapter, the learner will be able to :

CORONARY ARTERY DISEASE
ATHEROSCLEROSIS
Describe the clinical manifestation (C2)
Explain the physical examination (C3)
Describe the ECG, echocardiography (C2)
Interpret the radiological findings (C3)
Explain the management (c4)

At the end of the chapter, the learner will be able to describe the prevalence, physical examination, laboratory examination, and
management of MS & AR, MS & AS, AS & MS, AR & MR, and three-valve disease

89. At the end of the chapter, the learner will be able to :

RISK FACTOR FOR ATHEROSCLEROTIC DISEASE
Describe the structure and basic constituents of normal artery (C2)
Describe the structure and functions of vascular endothelium (C2)
Describe endothelial dysfunction (C2)
Illustrate the pathogenesis of atherosclerosis : respone to injury hypotesis; involvement and interaction of endothelial cells, smooth
muscle cells, monocytes, platelets, lipoprotein, and chemical mediators (C3)
Describe the risk factors for atherosclerosis (C2)
Illustrate the pathological hallmark : fatty streak, atheromatus plague (C3)
PRIMARY AND SECONDARY PREVENTION The pathologic features of atherosclerosis (C2)

90. At the end of the chapter, the learner will be able to :

illustrate the metabolism of lipoprotein : composition and function of lipoprotein (C3)
illustrate the biosynthesis, transport and excretion of cholestherol; regulation of cholesterol synthesis (C3)
describe the factors affecting cholesterol balance in the tissue (C2)
describe dyslipidemia (C2)
CORONARY BLOOD FLOW AND MYOCARDIAL
outline risk factors assessment (C4)
ISCHEMIA describe laboratorium of lipid profile (C2)

91. At the end of the chapter, the learner will be able to :

state the definition (C2)
make a scheme of classification of intervention (C4)
appraise risk factor management (C4)
describe the role of aspirin used as a secondary prevation og CAD (C4)

92. At the end of the chapter, the learner will be able to reviev:
STABLE AGINA PECTORIS
hypoxia and ischemia (C2)
determinant of myocardial oxygen consumption (C2)
regulation of coronary blood flow (C2)
coronary collateral circulation (C2)
consequences of myocardial ischemia (C2)
pathogenesis of myocardial ischemia

93. At the end of the chapter, the learner will be able to :

define non atherosclerotic causes (C1)
describe magnitude of the problem (C2)

PRINZMETAL (VARIANT) ANGINA
SYNDROME X (CHEST PAIN WITH NORMAL CORONARY ANGIOGRAM) 95. At the end of the chapter, the learner will be able to define :
SILENT MYOCARDIAL ISCHAEMIA
UNSTABLE ANGINA
ACUTE MYOCARDIAL INFARCTION
inventory clinical manifestations (C4)
interpret pathophysiology and granding of agina pectoris (C3)
describe biochemical findings (C2)
examine resting ECG (C4)
describe exercise ECG (C2)
state clinical application of non invasive testing (C1)
define invasive testing (C1)
make a scheme of medical management (C4)
describe the pharmacogolgic properties (mechanism of action, effects, adverse reactions, pharmacokinetics, indication and
contraindications and posology) of organic nitrat used in treatment of stable angina pectoris (C4)
describe the role of beta blocker and calcium antagonis used in the treatment o stable agina pectoris (C4)
difine percutaneous coronary intervention (C1)
define coronary artery bypass surgery (C1)
make a scheme of patient selection (C4)
calculate the prognosis (C4)
94. At the end of the chapter, the learner will be able to explain :
The mechanism (C1)
Clinical manifestations (C1)
ECG findings (C1)
The arteriographic studies (C1)
Explain the management (C1)
The prognosis (C1)
Mechanism (C1)
Clinical features (C1)
Physical and laboratory examination (C1)
Management
Prognosis (C1)
96. At the end of the chapter, the learner will be able to explain :
Categories of silent ischemia (C1)
ECG findings (C1)
Management (C2)
Prognosis (C1)
97. At the end of the chapter, the learner will be able to explain :
Definition and classification (C2)
Pathophysiology of unstable angina (C3)
Clinical presentation (C4)
ECG findings (C4)
The examination of cardiac markers (C4)
Coronary angiography findings (C1)
The outline of risk stratification (C4)
Differentiation with non ST elevation myocardial infarction (C4)
Conservative treatment (C4)
Invasive treatment (C1)
Invasive vs conservative treatment (C1)
98. At the end of the chapter, the learner will be able to :
Explain the pathology of acute plaque change (C2)
Explain the gross pathological change (C2)
Explain pathophysiology of left ventricular function, circulatory regulation, ventricular remodeling and other organ system (C3)
Examine clinical features (C4)
Discriminate laboratory examination : cardiac markers (C4)
Determine ECG finding (C4)
Examine chest X ray (C4)
Report echocardiography finding (C2)
Define nuclear imaging (C1)
Outline management (C4)
Outline hemodynamic disturbances, arrhythmias and other complication
Outline prehospital care (C4)
Outline general management in the emergency department (C4)
Define reperfusion on myocardial infarction (C1)
Explain coronary trombolysis (C2)
Define catheter based reperfusion (C1)
 Define surgical reperfusion (C1)
Distinguish antithrombotic antiplatelet therapy (C4)
Describe the role and the pharmacogolgic propertics (mechanism of action, effects, adverse reactions,
pharmacokinetics, contra indications and posology) of thrombolysis (strepptokinase) used in treatment of acute myocardial
Review convalescence, discharge, and post myocardial infraction care (C3)
Review risk stratification (C3)

99. At the end of the chapter, the learner will be able to explain the cardiac rabilitation of coronary artery disease (CAD) after myocardial
infraction :
ACUTE PHASE (CICU INPATIENT PHASE PROGRAM) PHASE I
o The affect of prolonged bed rest (C2)
o The educational programs as socialization of rehabilitation programs (C2)
o The gradual mobilization (C2)
o The gradual activities of daily living (ADL) or self care (C2)
o Gradual activities acoording to intensity / cardiac capacity (independent in ambulation and ADL (C2)

HEART DISEASE IN PREGNANCY CARDIOVASKULER PHYSIOLOGY
DURING PREGNANCY AND
PUERPERUM
CARDIOVASCULER EVALUATION DURING
PREGNANCY
CONGENITAL HEART DISEASE
MITRAL STENOSIS
MITRAL REGURGITATION, AORTIC STENOSIS,
AORTIC
REGURGITATION
PREGNANT PATIENTS WITH PROSTHESTIC VALVES
SUBACUTE / CONVALESENCE PHASE (In the ward or intermediate care / at home) PHASE II
o The intensive training programs based on the result of stress test in cardiac centre (supervised program) (C2)
o The home training programs independently as preparation before return home (C2)
o Psychiatric and phychological counseling and treatment
o The discharge with daily home programs and regular training in cardiac rehabilitation centre as non supervised
programs (C2)
CHRONIC STAGE (Post Discharge / in the Community) :
o Phase III : Traning phase / supervised
Phase IV : Maintenance Phase (non Supervised)
o The independent home programs training (C2)
o The regular training in cardiac rehabilitation centre (C2)
o The stress test and new program (C2)
o The program return to previous potition or activities (C2)
101. At the end of the chapter, the learner will be able to :
Explain the changes in blood volume during normal pregnancy (C2)
Explain the changes in cardiac output, stroke volume, heart rate, blood pressure and left ventricular ejection fraction and systemic
vascular resistance during normal pregnancy (C2)
Explain the hemodynamic changes during labor, delivery, cesarean section and the puerperium (C2)
102. At the end of the chapter, the learner will be able to :
Explain the history and physical findings durings normal pregnancy (C1)
Explain the ECG and chest radiographic findings (C2)
Define the Doppler and echocardiographic findings during normal pregnancy (C1)
Define recommendations related to intrauterine radiation exposure
103. t the end of the chapter, the learner will be able to explaine the risk of pregnancy and delivery of mother with cyanotic and non
cyanotic congenital heart disease as well as the risk to the fetus and newborn (C2)
104. At the end of the chapter, the learner will be able to :
Explain the hemodynamic consequencies of pregnancy in patient with mitral stenosis (C2)
Explain the treatment of mitral stenosis in pregnancy (C2)

HEMODYNAMIC CHANGES OF PREGNANCY IN

105. explain the hemodynamic con sequencies of pregnancy a patients with MR, AS, AR (C2)
PERIPARTUM
CARDIOMYOPATHY
106. explain the risk associated with pregnancy of patient with prosthetic valves (C2)
EPIDEMIOLOGY AND RISK FACTORS 107. explain about anticoagulantion in pregnancy (C2)

PRIMARY AND SECONDARY PREVENTION 109. explain the pathophyysiologic and pathologic features of PC (C2)

DIAGNOSIS
110. explain the epidemiology and risk factors of PC (C2)
NONINVASIVE TESTING
111. appraise risk factor management (C2)

112. inventory the clinical manifestations and differential diagnosis of PC

113. At the end of the chapter, the learner will be able to :

HEART FAILURE MANAGEMENT


Describe the biochemical changes as wel as the ECG
and X ray findings in PC (C2)
PATHOPHYSIOLOGY OF HEART Define the echocardiographic findings in PC (C1)
FAILURE
114. At the end of the chapter, the learner will be
able to outline :
The management during pregnancy, delivery and the
postpartum period (C4)
The complications (C4)
The Prognosis (C4)
CLINICAL ASPECTS OF HEART
Secondary prevention (C4)
FAILURE
100. At the end of the chapter, the learner will be
able to describe :
Short term adaptive mechanism (C2)
Chronic of myocardial remodeling (C2)
Molecular mechanisms myocardial remodeling
and ventricular failure (C2)
MANAGEMENT OF HEART FAILURE Pathophysiology of diastolic heart failure (C2)
Neurohormonal, autocrine and paracrine
adjustment (C2)
101. At the end of the chapter, the learner will be
Explain physical findings (C3)
Describe the laboratory findings : the lab test, ECG, and echocardiography (C2)
Interpret the chest roentgenogram of heart failure (C3)
Categorize the prognosis (C4)
102. At the end of the chapter, the learner will be able to solve :
Management of acute, new onset heart failure and chronic heart failure (C4)
Describe the role and the pharmacogolgic properties (mechanism of action, affects, adverse reactions, pharmacokinetics,
contraindications and posology) of digoxin used in treatment of heart failure (C4)
Describe the role of diuretics (furosemide and spironolcton) used in treatment of heart failure (C4)
103. At the end of the chapter, the learner will be able to describe :
The definitition of PE and cardiogenic shock (C2)
Mechanism of pulmonary edema (C2)
The imbalance of starling forces (C2)
The altered alveolar capillary membrane permeability ( RDS) (C2)
The lymphatic insufficiency (C2)
The unknown or incompletely understood mechanism
The cardiogenic pulmonary edema (C2)
The pulmonary edema of unknown pathogenesis (C2)
The difference of pulmonary edema with other diseases (C4)
Solve the management of pulmonary edema (C4)
The cardiogenic shock (C2)
Describe the role and the pharmacogolgic properties (mechanism of action, effects, adverse reaction, pharmacokinetics,
contraindications and posology) of inotropes (dopamine & dobutamine) used in treatment of cardiogenic shock (C4)

PULMONARY EDEMA & able to :

CARDIOGENIC SHOCK State the definition of heart failure (C1)
Describe the forms of heart failure (C2)

104. At the end of the chapter, the learner will be able to :

ARRHYTHMIA & CARDIAC ARREST ELECTROCARDIOGRAPHY
Describe and summarize the basic principle of electrocardiography (C2)
Illustrate and interpret the normal electrocardiogram (C3)
Illustrate and interpret abnormal electrocardiograms of coronary artery disease, cardiac arrhythmias, and conduction disturbances
(C3)

105. At the end of the chapter, the learner will be able to :

Describe and summarize the basic electrophysiologic principles, mechanism of arrhythmogenesis, and disorders of impulse
CARDIAC ARRYTHMIA
conduction (C2)
Perform a systematic approach to interpret the electrocardiogram of cardiac arryhtmias (C3)
Identify cardiac arrhythmias by exercise testing, holter monitoring, and invasive electrophysiologic syudies (C1)
Employ pharmacological therapy (C3)
Describe of electrotherapy with direct current electrical cardioversion (C2)
Define implantable electrical devices and ablation therapy (C1)
Define surgical therapy for cardiac arrhythmia (C1)
Describe of the clinical features ECG findings and therapy of sinus nodal disturbances (C2)
Examine the clinical features, ECG findings, and outlining and solving the therapy of atrial rhythm disturbances (C4)
Describe the clinical featuresi, ECG findings and the therapy of AV junctional rhythm disturbances (C2)
Examine the clinical features, ECG findings (C3), and outlining and solving the therapy for ventricular disturbances (C4)
Describe the clinical features, ECG findings and the therapy of atrioventricular block (C2)

TAKAYASU VASCULITIS

CARDIAC ARREST AND SUDDENT CARDIAC DEATH

ARTERIAL THROMBOEMBOLISM

A. DISEASE OF THE ARTERY

VASCULAR DISEASE BUERGERS DISE SE

ARTERIAL THROMBOSIS

ARTERIAL ANEURYSM Describe the role and the pharmacogolgic
properties (mechanism of action, effects, adverse
reaction, pharmacokinetics,
contraindications and posology) of anti arrhythmias
(amiodarone) used in treatment of cardiac
CHRONIC LOWER EXTREMITY
arrhythmia (C4)
ISCHEMIA
106. At the end of the chapter, the learner will be
able to describe :
Definition, epidemiology and causes of cardiac
arrest and sudden cardiac death (C2)
Pathology and pathophysiology of cardiac
arrest and sudden cardiac death (C2)
B. DISEASES OF THE VEINS
Examination of clinical characteristics of
MICROSCOPIC STRUCTURE OF THE
cardiac arrest and suddent cardiac death (C4)
VEINS
Community based intervention for cardiac
ACUTE DEEP VEINS THROMBOSIS arrest and sudden cardiac death (C4)
And summarize the therapy of cardiac arrest,
sudden death and post cardiac arrest care (C2)
Therapy for prevention of cardiac arrest and
sudden cardiac death (C2)
107. At the end of the chapter, the learner will be
procedures (C2)
111. At the end of the chapter, the learner will be able to summarize :
Epidemiology of this disease (C2)
Etiology and the pathogenesis concerning this disease (C2)
Signs and symptoms (C2)
Arteriographic findings (C2)
Conservative and operative treatment procedures (C2)
112. At the end of the chapter, the learner will be able to summarize :
Source of spontaneous embolism (C2)
The most frequent site if embolic occlusion (C2)
Clinical presentation (C2)
Pharmacologic therapy and surgical treatment option (C2)
113. At the end of the chapter, the learner will be able to summarize :
The phases of thrombosis and types of thrombi (C2)
The step, factors involved, and mechanism of platelet activation and aggregation (C2)
The mechanism and the pathways of blood coagulation (C2)
The mechanism of fibrinolysis (C2)
The regulation of thrombisis and fibrinolysis (C2)
114. At the end of the chapter, the learner will be able to describe :
Etiologic classification (C1)
Summarizing the primary disorders, mechanical factors in aneurysm formation (C2)
The signs of aneurysm (C2)
The indication of surgery (C2) and recalling the surgical treatment procedures (C1)

able to summarize :
Epidemiology of this disease (C2)
Etiology and the pathogenesis concerning the
association between heavy tobacco use and this
disease (C2)
Gene associated with this disease (C2)
Abnormality of hypercoagulability and
endothelial function in this disease (C2)
Inflammatory thrombosis that affects the
arteries and veins (C2)
Clinical features of Buergers disease (C2)
Diagnosticncriteria (C2)
Characteristic arteriographic findings (C1)
Pathologic feature of buergers disease (C2)
Differential diagnosis of the disease that mimic
buergers disease (C2)
Conservative and operative therapeutic
115 At the end of the chapter, the learner will be able to summarize :
Risk factor (C2)
Natural history (C2)
Physical examination (C2)
Ultrasonographic and arteriographic findings (C1)
Medical and surgical treatment (C2)
116. At the end of the chapter, the learner will be able to explain the general structure of the veins (C2)
117. At the end of the chapter, the learner will be able to summarize :
The pathophysiology (C2)
The signs and symptoms (C2)
The ultrasounic and phlebographic examinations (C1)
The use anticoagulants (C2)
The use of intermittent and graduated leg compression (C2)
The sclerotherapy of the superficial limb vein (C2)

CORPOLMONALE

PERICARDITIS & CARDIAC

TAMPONADE
 findings (C1)
Solves the management (C4)
The surgical treatment (C2)
124. At the end of the chapter, the learner will be able to :
CHRONIC VENOUS INSUFFICIENCY 118. At the end of the chapter, the learner will be
Describe the pathophysiology (C2)
able to describe : Examine the history and physical findings (C4)
Analyzenthe ECG (C3)
The natural history, such as the risk factors
Describe the radiological findings (C2)
and the pathophysiology (C1)
Describe the echocardiogram (C2)
The signs and symptoms (C2)
Identify the cardiac catheterization (C1)
The clinical procedure for diagnosis of venous
Describe the medical treatment (C2)
reflux (C2)
Describe the surgical treatment (C2)
C. DISEASES OF THE LYMPHATIC The pathologic features of varicouse vein (C2)
SYSTEM The medical treatment (C2) 125. At the end of the chapter, the learner will be able to :
MICROSCOPIC STRUCTURE OF THE The surgical treatment options (C2)
LYMPH VESSEL Describe the etiology, natural history, pathology and pathophysiology
LYMPHEDEMA Describe the history, physical examination and laboratory findings (C2)
Describe the radiological findings (C2)
119. At the end of the chapter, the learner will be
Describe the ECG and echocardiogram (C2)
able to describe the histologic structure of lymphatic Identify the CT, MRI and cardiac catheterization findings (C1)
Describe the management.
vessel wall (C1)
120. At the end of the chapter, the learner will be 126. At the end of the chapter, the learner will be able to :
able to explain : The normal pulmonary circulation (C2)
The lymphatic drainage (C1) The respone to hypoxia, drugs, and neural and environmental factors (C2)
The pathogenesis of obstruction and the The diagnostic classification of pulmonary hypertension (C2)
compensatory mechanisms in the development of Secondary pulmonary hypertension (C2)
ACUTE PERICARDITIS lymphedema (C2)
The etiologic classification of lymphedema
(C1)
Signs and symptoms of lymphedema (C2)
The complications of lymphedematous limb
(C2)
MYOPERICARDITIS
The lymphoscintigraphy and lymphography
(C1)
The pharmacologic and physical therapy (C2)
The surgical treatment procedures

121. At the end of the chapter, the learner will be

PERICARDIAL EFFUSION
able to :
Describe the epidemiology and etiology (C2)
Describe the history, physical findings and the
ECG (C3)
Describe the treatment (C2)

122. At the end of the chapter, the learner will be

CARDIAC TAMPONADE
able to :
Describe the etiology, pathogenesis and
pathology (C2)
Describe the history and physical findings (C2)
Describe the biochemical findings (C2), and
ECG (C3)
Describe the echocardiogram, nuclear imaging
and MRI findings (C2)
Describe the management (C2)

123. At the end of the chapter, the learner will be

CINSTRICTIVE PERICARDITIS able to :

Describe the epidemiology, etiology, and
natural history (C2)
Examine the pathogenesis and pathology
Examine the history and physical findings (C4)
Examine the laboratory findings (C4)
Examine the radiological findings (C3) chest x-
ray, USG (C2), and ECG (C3)
PULMONARY HYPERTENSION Describe the echocardiogram (C2)
Identify the CT, MRI and nuclear imaging

COR PULMONALE SECONDARY TO LUNG DISEASE CHRONIC OBSTRUCTIVE PULMONARY DISEASE

 127. At the end of the chapter, the learner will be able to explain :
THE CARDIOVASCULAR DISEASE IN A. HEART FAILURE
THE ELDERLY
PATHOPHYSIOLOGY, DRUG METABOLISM,
EPIDEMIOLOGY
VALVULAR HEART DISEASE
History and physical examination (C2)
Hematological and chemical findings (C2)
Interpreting the radiological findings (C3)
Interpreting the electrocardiographic findings (C3)
Describing the echocardiography (C2)
Difining the radionuclide ventriculography, CT, and MRI (C1)

128. At the end of the chapter, the learner will be able to describe :
CORONARY ARTERY DISEASE
The epidemiology of pulmonary hypertension (C2)
B. HYPERTENSION The hemodynamic changes (C2)
The treatment (C2)
C. CARDIOMYOPATHY & ARRHYTMIAS The rehabilitation (C2)
Blood Gas Analysis : metabolic acidosis & alkalosis
Blood Gas Analysis : respiratory acidosis & alkalosis

At the end of the chapter, the learner will be able to :

129. summarize the pathophysiology, drug metabolism and epidemiology (C2)

130. describe the diagnosis and treatment (C2)

131. summarize the prevalence, incidence, risk factors clinical presentation, diagnosis and management (C2)

132. summarize the epidemiology and treatment (C2)

133. summarize the most common cardiomyopathy and arrihythmias in elderly