Hypertension
Hypertension is a common disorder that is defined as sustained elevation of systolic blood pressure (BP) > 160 mmHg and/or diastolic BP > 90 mmHg. Three successive readings are typically required for diagnosis.
What to learn
Risk factors and causes of primary and secondary hypertension
Ischemic heart disease (IHD)
Ischemic heart disease is a condition caused by reduction or cessation of the blood supply to the myocardium. It gives rise to four main syndromes: stable angina, unstable angina, myocardial infarction, and sudden cardiac death. The most important cause of IHD is atherosclerosis.
What to learn
Pathophysiology and causes of atherosclerosis
Cardiac risk factors
Diagnosis and management of myocardial infarction
Interventions and drugs in the long-term management of IHD
Heart failure
Heart failure can be defined as the inability of the heart to maintain sufficient cardiac output to adequately perfuse the tissues for normal metabolism. It can be caused by conditions that damage heart muscle (e.g., IHD or cardiomyopathies) or that demand increased work of the heart (e.g., systemic hypertension or valvular heart disease).
What to learn
Causes of heart failure
Symptoms and signs of right- and left-sided heart failure
Arrhythmia
Any deviation from the normal sinus rhythm of the heart is known as an arrhythmia. Arrhythmias are classified clinically by site of origin (supraventricular or ventricular) and heart rate (bradycardia or tachycardia).
What to learn
How to spell 'arrhythmia'
Causes of and risk factors for arrhythmia
Recognition of the big four: atrial fibrillation (AF), heart block, ventricular tachycardia (VT) and ventricular fibrillation (VF).
Treatment protocols: drugs, cardioversion, ablation, and defibrillation
Thromboembolic disease
This condition involves the pathological formation of thrombus and its acute complication of embolus, especially to the pulmonary vasculature. Pulmonary embolus accounts for 1% of all hospital deaths. Ninety percent of deep vein thromboses (DVTs) occur in the deep veins of the lower limb.
What to learn
Understand Virchow's triad and learn the specific risk factors for thrombosis: immobility, cardiac failure, pregnancy, the combined oral contraceptive pill (COCP), and varicose veins
Symptoms and signs of DVT and pulmonary embolism (PE)
Classification of PE from major to minor and the emergency management of PE
Anticoagulation and its role in thromboembolic disease
Heart valve disorders
Diseases of the heart valves produce two types of disorders, stenosis and regurgitation, which can coexist in the same valve. Valvular disease can be caused by damage to the valve leaflets or to the valve ring, or can be secondary to damage to the papillary muscles or chordae. Important mechanisms include degenerative calcification, rheumatic heart disease (the incidence of which is declining), and infective endocarditis.
What to learn
Concentration on the big four: mitral stenosis, mitral regurgitation, aortic stenosis, and aortic regurgitation.
Symptoms and signs of aortic and mitral valve disease.
Causes, in particular calcification, endocarditis, and rheumatic heart disease.
Types of valve replacement and the precautions necessary in patients who have replacements.
Peripheral vascular disease
Peripheral vascular disease is a common degenerative disease of the blood vessels, in particular of the arteries. It results in a number of specific problems, including acute and chronic ischemia of the legs, ischemia of the organs (e.g. kidneys, brain, bowel), and aortic aneurysm. It can be due to a number of pathological processes, including arteriosclerosis and atheroma formation.
What to learn
Risk factors for peripheral vascular disease: smoking, hypertension, lipids, etc.
Mechanisms of arteriosclerosis and atherosclerosis and the changes that occur in the artery walls.
Ischaemia of the legs: symptoms, signs and management.
Aortic aneurysm: definitions, diagnosis and treatment.
