Cardiovascular Illness

Overview

Cardiology is the prevention, diagnosis, and management of disorders of the cardiovascular

system, including ischemic heart disease, cardiac dysrhythmias, cardiomyopathies, valvular heart

disease, pericarditis and myocarditis, endocarditis, congenital heart disease in adults,

hypertension, and disorders of the veins, arteries, and pulmonary circulation. Management of

risk factors for disease and early diagnosis and intervention for established disease are important

elements of cardiology.

The general internist should be able to provide primary and secondary preventive care and

initially manage the full range of cardiovascular disorders. The need for additional competencies

in cardiovascular disease will depend on the availability of a cardiologist in the primary practice

setting. In some communities, the general internist may be responsible for management of more

complex cardiovascular disorders that require intensive hemodynamic monitoring (for example,

balloon-tipped pulmonary artery catheters) in the intensive care unit.

Common Clinical Presentations

h Abnormal heart sounds or murmurs

h Chest pain

h Dyspnea

h Effort intolerance, fatigue

h Hypertension

h Intermittent claudication

h Leg swelling

h Palpitations

h Peripheral vascular disease

h Risk factor modification

h Shock, cardiovascular collapse

h Syncope, lightheadedness

Procedure Skills

h Advanced cardiac life support

h Insertion of balloon-tipped pulmonary artery catheter (optional)

h Insertion of temporary pacemaker (optional)

Primary Interpretation of Tests

h Stress electrocardiography (optional)

Ordering and Understanding Tests

h Ambulatory ECG monitoring

h Echocardiography

h Electrophysiology testing

h Left ventricular catheterization and coronary angiography

h Nuclear scan wall motion study

h Right ventricular catheterization (including flotation catheter)

h Stress electrocardiography and thallium myocardial perfusion scan

h Tilt-table physiology study