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Curriculum for Cert Cardiology(SA)

1. Basic Sciences for Cardiovascular Disease:
    Anatomy, physiology, pathophysiology and pathology of cardiovascular
    diseases

1.1 Molecular biology:
• Genetics relevant to cardiovascular disease
• Cellular function:
• Ion channels
• Excitation/contraction coupling
• Receptor function
• Endothelial function
• Circulating factors:
Cytokines
Renin-angiotensin system
Other:
Natriuretic peptides
Endothelin

1.2 Autonomic nervous system:
• Cardiovascular reflexes
• Circulating factors

1.3 Cardiovascular haemodynamics:
• Circulatory regulation
• Myocardial performance
• Pathophysiology of valvular, myocardial, ischaemic, pericardial and
congenital heart disease
• Heart failure

1.4 Electrophysiology:
• Conduction system:
Anatomy
Function
• Mechanisms of arrhythmias:
Conduction disorders
Re-entry
Automaticity
Triggered automaticity

1.5 Pathology/pathophysiology of specific conditions:
• Arrhythmias
• Cardiomyopathies
• Congenital heart disease
• Ischaemia
• Pericardial disease
• Tumours of the heart and pericardium
• Valvular heart disease
• Vascular disease

    • Scientific basis of treatment methods and investigations:

 

      • ECG – including signal-averaged ECG:

1.6.2              Imaging techniques:
• Echocardiogram – including stress echo and intracardiac ultrasound
• MRI
• Nuclear imaging
• X-rays – including radiation biology and radiation protection

1.6.3   Pharmacology/drugs:
1.6.3.1 All drug classes affecting the cardiovascular system and/or used for
           treatment of cardiovascular disorder, including but not limited to:

• ACE inhibitors and angiotensin receptor blockers
• Antiarrhythmics
• Antihypertensives
• Antithrombotic agents (including antiplatelet
agents)
• Beta blockers
• Calcium channel blockers
• Cardiac glycosides
• Catecholamines and inotropes
• Diuretics
• Lipid lowering agents
• Nitrates
• Vasodilators

1.6.4             Resuscitation/defibrillation:

1.6.5             Electrical cardioversion:

1.6.6             Percutaneous coronary intervention:
• Balloon angioplasty
• Stents

1.6.7             Implantable electrical devices:
• Pacemakers
• Implantable cardioverter/defibrillators
• Cardio resynchronisation therapy

1.6.8             Catheter ablation:
• Arrhythmias
• Septal ablation

1.6.9             Other interventions:
• Balloon valvotomy
• Occluder devices

1.6.10          Cardiac surgery/cardiopulmonary bypass

2.  Clinical aspects of cardiovascular medicine, relevant investigations and
    Management

2.1 Clinical skills:
Since candidates have passed the FCP(SA), or equivalent, it is assumed that
they are competent general physicians. Specific knowledge of the full spectrum of cardiovascular disease, at the level of competent general cardiologist is expected. Awareness of and ability to recognize certain rare, but important, conditions is also required.

2.2 Cardiovascular diseases/conditions:
• Arrhythmias
• Cardiomyopathies
• Congenital heart disease (adult)
• Heart failure
• Ischaemia
• Pericardial disease
• Tumours of heart and pericardium
• Valvular heart disease
• Vascular disease

2.3 Indications for investigations and interventions:
• Balloon valvuloplasty
• Catheter ablation of arrhythmias
• Cardiac catheterisation/angiography
• Cardiac surgery
• Cardioversion
• ECG:
? Holter
? Stress
? Signal-averaged
• Echocardiography:
? Transthoracic
? Transoesophageal
? Stress echo
• Electrophysiological studies
• Implantable cardioverter defibrillator (ICD)
• Intra-aortic balloon pump
• MRI and CT
• Nuclear imaging
• Pacemaker insertion:
? Temporary
? Permanent
• Percutaneous coronary intervention:
? PTCA
? Stent insertion
• Pericardiocentesis
• Swan-Ganz catheterisation

 

2.4 Interpretation of investigations:
• Electrocardiograms
• Radiographs
• Angiograms
• Echocardiograms

2.5 Procedural skills:
• Resuscitation and advanced cardiac life support
• Electrical cardioversion
• Central and peripheral venous and arterial access for diagnostic and
therapeutic procedures
• Cardiac catheterisation – diagnostic:
? Right heart:
? Pressures
? Shunt measurement
? Angiograms:
? Right ventricle
? Pulmonary arteries
? Left heart:
? Retrograde
? Trans-septal
? Angiograms:
? Left ventricle
? Aortogram
? Coronary arteries
• Echocardiography:
? Transthoracic
? Transoesophageal
• Therapeutic procedures:
? Insertion of intra-aortic balloon pump
? Temporary pacemaker insertion
? Permanent pacemaker implant:
? Pacemaker follow-up; programming; troubleshooting
? Pericardiocentesis
? Mitral balloon valvuloplasty
? Percutaneous coronary interventions:
? PTCA
? Stent insertion

2.5 Cardiovascular epidemiology:
• Assessment and management of risk factors

2.6 General:
• Analysis and interpretation of clinical trials and critical appraisal of
evidence
• Use of resources
• Communication with patients and colleagues
• Relationship to cardiovascular surgeons
• Judgement as to when to refer to another specialist

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