Clinical Cardiology - VAMC

Course Description:

1. This course provides an overview of most areas of cardiology. In a 2-week elective, the first week is a combination of observing noninvasive testing of all types and seeing patients directly in clinic, with attendings. ECG/ECHO/Stress/Nuclear Stress/MRI/sometimes CTA /sometimes TILT testing are observed in this manner. During the second week, invasive testing is observed, generally CV/TEE; cath; PCI; EP Study and device implant or upgrade; ablation. The 4-week elective includes a week of outpatient heart failure. The fourth week enables an interested student to go back for more exposure in areas they liked or just felt they wanted more experience of. For students thinking about going into Cardiology, we strongly recommend the month-long version of the rotation.
2. Experience with patients with Coronary Artery Disease or ASHD. Develops understanding of physiological testing involved in the care of patients with known or suspected CAD. Students will have the opportunity to interview and examine a variety of patients referred to cardiology for chest pain evaluation, either by an ER or from their primary care team. Selection of testing modalities will be reviewed and for the 4-week rotation the student will be able to assist with the testing and then see the patient afterward. This can sometimes be accomplished in the 2-week rotation. Read accompanying chapter in Up to Date. This can readily be accomplished during this rotation.
3. Experience patients with Atrial Fibrillation. Students will have the opportunity to interview and examine patients referred for palpitations and irregular heartbeat. We have so many patients with Atrial fibrillation, this condition will certainly be seen during the rotation and many students have had the opportunity to see routine plus TEE echos and often they assist with cardioversion.
4. Experience patients with heart failure. During the 4-week rotation, a full week is generally devoted to this topic. VA is a non LVAD, non heart transplant center so we are referring to pre transplant heart failure care.
5. Learn to examine the cardiovascular patient in a focused manner and how to write consult notes.

Course Learning Objectives:

By the end of this course, the student should be able to:

1. Practice basic skills in obtaining a history and performing a focused physical exam on a cardiovascular patient.
2. Identify common clinical presentations, evaluation and management of cardiovascular disorders (e.g., CAD/HF/AFIB).
3. Recognize indications for appropriate invasive and non-invasive tests for cardiovascular disorders.
4. Demonstrate ability to write consult notes.

• In the four-week rotation, students will have an additional week-long experience in heart failure and additional time to observe other procedures.