Back Module: S-CS-S1

Cardiac Core

Module information

Module details

Title
Cardiac Core
Type
Specialist
Module code
S-CS-S1
Credits
20
Phase
2
Requirement
Compulsory

Aim of this module

This module aims to build an in depth understanding of key diagnostic tests and therapies used within Cardiac Science. The module aims to develop trainees skills in performing diagnostic tests/technical support, and to engrain the importance of the wider clinical picture. Emphasis is made on developing a sound understanding of clinical presentations, patient pathways and prognosis seen in a variety of common cardiac pathologies. The module aims to form the building blocks of becoming a competent and well-rounded Cardiac Scientist, whilst preparing the individual for advanced specialism.

Work-based content

Training activities

# Learning outcome Training activity Type Action
# 1 Learning outcome 1,2,3,4,5,8 Training activities

Prepare a patient for the following:

  • ECG
  • Ambulatory monitor
  • TTE
  • Device implant
  • Device follow-up
 Type DTA Action View
# 2 Learning outcome 1 Training activities

Perform and interpret the following diagnostic tests:

 

  • 12 lead ECG
  • Ambulatory monitoring
 Type ETA Action View
# 3 Learning outcome 1,8 Training activities

Review and recommend further diagnostic tests/treatments based on the following ECG findings:

  • AV blocks
  • Atrial fibrillation and flutter
  • Ischaemic changes
  • Tachyarrhythmias
  • SA node disease
 Type DTA Action View
# 4 Learning outcome 2,8 Training activities

Obtain images for a standard trans-thoracic echocardiogram in an adult patient under supervision

 Type ETA Action View
# 5 Learning outcome 2 Training activities

Make accurate measurements according to national guidelines for a normal echo

 Type DTA Action View
# 6 Learning outcome 2 Training activities

Analyse and interpret the results of the normal trans-thoracic echo and produce a report under supervision

 Type DTA Action View
# 7 Learning outcome 3 Training activities

Select the appropriate pacing device for an implant based on patient presentation

 Type DTA Action View
# 8 Learning outcome 3,4,8 Training activities

Perform accurate lead measurements:

  • At device implant
  • During follow up
 Type DTA Action View
# 9 Learning outcome 4 Training activities

Interpret and analyse device data making reprogramming recommendations

 Type DTA Action View
# 10 Learning outcome 4,5,8 Training activities

Enroll a patient for home monitoring

 Type ETA Action View
# 11 Learning outcome 5 Training activities

Prepare ILR for implant

 Type ETA Action View
# 12 Learning outcome 5,8 Training activities

Analyse and accurately report ILR results

 Type ETA Action View
# 13 Learning outcome 6,8 Training activities

Prepare and maintain good quality haemodynamic and ECG monitoring throughout a case in the cath lab

 Type ETA Action View
# 14 Learning outcome 6,8 Training activities

Interpret invasive haemodynamic data for patients presenting with the following pathologies:

  • Heart failure
  • Valve disease
  • Pulmonary hypertension
  • Pre/post TAVI
  • ASD/PFO closure
  • CAD
 Type DTA Action View
# 15 Learning outcome 3,6,8 Training activities

Monitor and respond to patient changes during a procedure in the lab

 Type ETA Action View
# 16 Learning outcome 6,7,8 Training activities

Explain the role, procedure and expected outcomes of coronary angiography to a patient with reference to their clinical presentation

 Type DTA Action View
# 17 Learning outcome 1,2,7,8 Training activities

Review and evaluate the clinical pathways for patients with the following presentations and present to colleagues:

  • Chest pain
  • Dyspnoea
  • Palpitations
  • Syncope
 Type DTA Action View
# 18 Learning outcome 7,8 Training activities

Review pharmacological treatments for patients presenting with the following and discuss with supervisor:

  • Chest pain/coronary disease
  • Heart failure
  • Hypertension
  • Atrial fibrillation
 Type DTA Action View
# 19 Learning outcome 7,8 Training activities

Triage diagnostic requests

 Type DTA Action View
# 20 Learning outcome 6,8 Training activities

Recognise, intervene and monitor a deteriorating patient

 Type ETA Action View

Assessments

Complete 4 Case-Based Discussions

Complete 4 DOPS or OCEs

Direct Observation of Practical Skills Titles

  • Set up an ILR prior to implant.
  • Provide technical support for pacemaker implant in the cath lab.
  • Obtain and optimise the standard views in a transthoracic echo.
  • Make standard measurements for a normal transthoracic echo.
  • Perform a check of resuscitation equipment.
  • Perform pacemaker follow-up and ensure safe and correct function of the device.
  • Enroll a patient onto a home monitoring system.

Observed Clinical Event Titles

  • Gather a patient history.
  • Explain a cardiac angiogram procedure to a patient.
  • Explain to a patient post PPM implant care.
  • Obtain valid consent from a patient for a diagnostic test.
  • Discuss the results of a test and the indications for further diagnostic tests or treatment with colleague.

Learning outcomes

# Learning outcome
1

Perform and interpret 12-lead and ambulatory ECG monitoring to construct a detailed report and make recommendations regarding further investigations and/or clinical management.
2

Perform a trans-thoracic echocardiogram by acquiring and interpreting the standard images to prepare a report for a patient with a structurally normal heart.
3

Provide effective physiological and scientific support for pacemaker implant, providing technical expertise, ensuring patient safety and appropriate procedural documentation.
4

Perform and interpret routine follow-up of pacemakers and make appropriate programming changes to ensure safe functioning of the device.
5

Prepare and setup for implantable loop recorder (ILR) insertion and manage follow-up post implant, including use of remote monitoring.
6

Interpret haemodynamic data for patients presenting to the cardiac cath lab with a range of conditions, recognising the role of these procedures within the patient pathway, limitations of diagnostics and troubleshooting where required.
7

Critically appraise the role of cardiac diagnostic procedures within a range of patient presentations and pathways.
8

Demonstrate the ability to communicate effectively with patients, carers and the wider multidisciplinary team.

Clinical experiences

Clinical experiences help you to develop insight into your practice and a greater understanding of your specialty's impact on patient care. Clinical experiences should be included in your training plan and you may be asked to help organise your experiences. Reflections and observations from your experiences may help you to advance your practice and can be used to develop evidence to demonstrate your awareness and appreciation of your specialty.

Activities

  1. Observe a general cardiology outpatient clinic and presentation of patients with a range of conditions.
  2. Observe a ward round on coronary care unit and follow a patient, with permission, from their acute presentation to discharge, considering the role of cardiac diagnostics in this journey.
  3. Attend a multidisciplinary team meeting and reflect on how the multidisciplinary team members each contribute to management of patients with cardiac conditions.
  4. Attend a clinical governance/audit meeting and consider the role of diagnostics within the wider service provision.
  5. Observe electrophysiological mapping and ablation.
  6. Observe TOE and DSE/ESE.
  7. Observe a cardiac MRI to appreciate the advantages and limitations of this imaging modality in Cardiology practice.
  8. Attend a cardiac rehabilitation session or clinic visit to appreciate the importance of prevention in disease management.
  9. Visit a community based cardiac support service e.g., heart failure clinic.

Academic content (MSc in Clinical Science)

Important information

The academic parts of this module will be detailed and communicated to you by your university. Please contact them if you have questions regarding this module and its assessments. The module titles in your MSc may not be exactly identical to the work-based modules shown in the e-portfolio. Your modules will be aligned, however, to ensure that your academic and work-based learning are complimentary.

Learning outcomes

On successful completion of this module the trainee will be able to:

  1. Explain the practical requirements for performing transthoracic echocardiography.
  2. Analyse and interpret transthoracic echocardiograms for patients with structurally normal hearts.
  3. Explain the practical requirements for providing scientific support during implantation of cardiac devices.
  4. Critically evaluate pacemaker function and programming adaptations to optimise treatment.
  5. Critically appraise haemodynamic data acquired during catheter lab investigations.

Indicative content

General:

  • Typical presentation, diagnostic techniques used and treatment options for a range of cardiac diseases (to include: heart failure, cardiomyopathies and inherited arrhythmogenic disorders)
  • Major cardiac drug groups

Cardiac ultrasound:

  • Role of ultrasound in the patient pathway
  • Physics/instrumentation and its application to cardiac ultrasound
  • Echo anatomy and physiology
  • Artefacts and optimisation
  • Image quality – acquisition and optimisation
  • Digital acquisition and storage
  • Cardiac function parameters and measurements (including Doppler haemodynamics)
  • Minimum dataset for a standard adult transthoracic echocardiogram
  • Limitations to cardiac ultrasound and alternative imaging modalities
  • Emerging techniques and innovations

Cardiac haemodynamic and angiographic investigations:

  • The cardiac cycle
  • Coronary disease and angiographic investigations
  • Pressure transducer technology (to include single or dual pressure bag systems, calibration and use of haemodynamic monitoring systems)
  • Catheter design and purpose
  • Normal pressure waveforms and normal value ranges
  • Abnormal recordings and associated pathology

Cardiac rhythm management:

  • Physics related to pacing technology
  • Pulse generator technology
  • Battery technology
  • Sensing and capture
  • Timing cycles and algorithms
  • Rate response technology
  • Lead and hardware problems
  • Implantation technique and measurements performed
  • Chest X-ray review post device implant

Implantable loop recorders:

  • Device usage and indications
  • Implant measurements and observations

Module assigned to

Specialties

Specialty code Specialty title Action
Specialty code SPS1-1-22 Specialty title Cardiac Science [2022] Action View
Specialty code SPS1-1-23 Specialty title Cardiac Science [2023] Action View
Specialty code SPS1-1-24 Specialty title Cardiac Science [2024] Action View
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