Cardiovascular

• Upon completion of this problem, students should be able to explain cardiac electrical impulse conduction.
• Upon completion of this problem, students should be able to describe the normal fetal circulation and explain how disrupted blood flow patterns can lead to cyanosis and organ dysfunction.
• Explain the most common mechanism of arrhythmogenesis: re-entry
• Upon completion of this problem, students should be able to describe the pathophysiology of atherosclerosis and its relationship to cardiovascular disease.
• Upon completion of this problem, students should be able to explain the pathophysiology of the acute coronary syndromes.
• Upon completion of this problem, students should be able to describe the cardiac cycle, the mechanisms of myocardial contraction and the pathophysiology of congestive heart failure.
• Upon completion of this problem, students should be able to describe how pressure overload affects myocardial function.
• Upon completion of this problem, students should be able to describe how volume overload affects myocardial function.
• Upon completion of this problem, students should be able to explain the potential complications of acute myocardial infarction.
• Upon completion of this problem, students should be able to describe the mechanisms by which cardiomyopathy leads to decompensated heart failure.
• Explain the genesis of the resting membrane potential of myocardial cells.
• Explain the action potential in different types of cardiac cells.
• Explain the relationship between cardiac impulse conduction and the electrical events recorded on the surface EKG (normal 12-lead and during bradyarrhythmia).
• Describe a stepwise approach to the diagnosis of tachyarrhythmias.
• Describe a basic approach to management of patients with re-entrant supraventricular tachyarrhythmias.
• Describe the cardiac cycle and explain how electrical depolarization of the heart muscle is related to the mechanical events of atrial and ventricular contraction.
• Explain a pressure-volume loop diagram of the left ventricle during the cardiac cycle.
• Explain the pressure wave forms in the aorta, left ventricle and left atrium, and compare them to those in the pulmonary artery, right ventricle and right atrium.
• Explain the four major determinants of ventricular performance.
• Explain the mechanism(s) resulting in pulmonary and peripheral edema in patients with congestive heart failure.
• Describe a mechanism-based approach to management of CHF.
• Explain the delivery of blood to the myocardium (coronary circulation, determinants of coronary blood flow).
• Explain how heart (and skeletal) muscle utilizes oxygen to generate energy for contraction.
• Explain the process of atherosclerosis and the risk factors associated with its development.
• Explain the pathophysiology of angina.
• Explain the pathophysiology of acute myocardial infarction.
• Compare and contrast acute myocardial infarction, unstable angina and stable angina.
• Describe a mechanism-based approach to the management of unstable angina and acute myocardial infarction.
• Describe complications of an acute myocardial infarction.
• Describe the hemodynamic findings in cardiac tamponade.
• Describe the structure and function of the atrioventricular valves.
• Explain the pathophysiology and clinical presentation of acute and chronic mitral regurgitation.
• Explain the hemodynamic effects of mitral regurgitation on ventricular function.
• Explain the deterioration in ventricular function following valve replacement.
• Briefly review infectious endocarditis.
• Describe the structure and function of the semilunar valves.
• Explain the pathophysiology and clinical presentation of aortic stenosis.
• Explain the hemodynamic effects of aortic stenosis on left ventricular function.
• Describe the pathophysiology of cardiomyopathy.
• Describe the identifying features of each type of cardiomyopathy.
• Describe main hemodynamic findings of each type of cardiomyopathy.
• Explain diastolic heart failure.
• Explain how atrial fibrillation leads to heart failure.
• Explain mechanisms and causes of an elevated troponin and BNP.
• Describe the transitional circulation in the neonate.
• Explain how disrupted flow patterns contribute to congestive heart failure.
• Compare and contrast cyanotic versus non-cyanotic congenital heart disease
• Recognize the elements of tutorial dysfunction and develop tools to manage them.
• Describe their own learning strategies and identify areas for improvement.
• Evaluate their own feedback skills.
• Recognize progress made to date (learning process, communication, professionalism, wellness).
• Upon completion of this problem, students should be able to demonstrate integration of knowledge from across MF1.
• What causes pleural effusions? How are they diagnosed?
• How are pleural effusions managed?
• Explain the findings on an EKG in a patient in normal sinus rhythm.
• Explain the findings on an EKG in a patient with tachyarrhythmia.
• Describe what happens with the electricity in the heart during sinus rhythm, supraventricular tachycardia and ventricular tachycardia.
• Recognize non-coronary atherosclerosis, and the clinical syndromes that may result as a consequence of atherosclerotic involvement of the peripheral vascular system.
• Upon completion of this problem, students should be able to describe the fundamentals of normal cardiac anatomy and physiology along with the key elements of the electrical conduction system. Students will be able to describe the cardiac cycle and electro-mechanical interactions in the normal heart.
• Describe the basic elements of normal left ventricular function.
• Describe the cardiac cycle (systole and diastole) and explain how electrical depolarization of the heart muscle is related to the mechanical events of atrial and ventricular myocardial contraction.
• Explain the pressure-volume loop diagram of the normal left ventricle during the cardiac cycle.
• Describe the correlation of basic cardiac auscultation findings (heart sounds) and the main waves on the electrocardiogram (Wiggers diagram).
• Describe the anatomy of the cardiac electrical conduction system and its correlation with the ECG waves and intervals.
• Examine how EDI (equity, diversity, and inclusion) elements have been incorporated into tutorial learning thus far, and reflect on the group’s strengths or areas of improvement regarding EDI content.
• Discuss the importance of community and individual social and economic status factors (poor housing, nutrition, poverty, etc.) on health outcomes.
• Understand the pathophysiology of pulmonary shunting and V/Q mismatch.
• Describe how lung pathology leads to the development of cor pulmonale, and to cardiopulmonary shock.
• Describe the pathophysiology of shunting and physiological responses to V/Q mismatch.
• Explain the pathophysiology of right heart failure in the context of major pulmonary embolism.
• Identify the current concepts and evidence for strategies for acute diagnostic approach in patients with suspected pulmonary embolism and undifferentiated shock.