Description

Timeframe: from diagnosis of a chronic coronary syndrome until effective treatment or referral

 

Setting: outpatient setting, inpatient setting, and emergency department

 

Including:

 

performance and interpretation of basic diagnostic modalities

 

interpretation of additional diagnostic modalities

 

medical management

 

secondary prevention

 

indication for coronary angiography and/or revascularization strategies

 

Excluding: performing interventional or surgical therapy

CanMEDS roles
  • Medical expert

  • Communicator

  • Collaborator

  • Health advocate

Knowledge
  • Outline the epidemiology of and risk factors for chronic coronary syndromes

  • Describe the molecular and cellular biology of chronic coronary disease

  • Outline the essential features of normal coronary physiology

  • Describe the pathophysiology of myocardial ischaemia, including stunning, hibernation, and viability

  • Describe the events that precipitate angina

  • Discuss the prognosis of chronic coronary syndromes

  • Describe the indications for utilization of specific diagnostic procedures including rest ECG ambulatory ECG, stress test in its different modalities, echocardiography, cardiac computed tomography angiography, cardiac magnetic resonance imaging (MRI), and invasive coronary angiography

  • Analyse the interpretation of non-invasive tests based on Bayes’ theorem

  • Discuss the interpretation of invasive tests

  • Describe medical therapy of chronic stable angina

  • Consider the indications for revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) and the factors that favour one approach over the other

  • Discuss the importance of co-morbidities in the management and prognosis of chronic coronary syndromes

Skills
  • Take a relevant history and perform an appropriate clinical examination

  • Incorporate risk stratification to planning the individual management strategy

  • Identify and treat risk factors for coronary artery disease including lifestyle modification

  • Utilize appropriate therapies for secondary prevention (see specific EPAs) and myocardial ischaemia

  • Manage arrhythmias associated with chronic coronary syndromes

  • Select appropriate patients for referral for revascularization by PCI or CABG

  • Make recommendations on the need for diagnostic tests during follow-up

  • Perform and interpret basic diagnostic modalities and manage emergencies occurring during the test (see specific EPAs)

  • Assess and manage co-morbidities with the help of other specialists

Attitudes
  • Support the Heart Team and, where appropriate, other physicians

  • Maintain consistent adherence to agreed evidence-based protocols in collaboration with off-site interventional cardiologists and cardiac surgeons in the absence of on-site cardiac surgery and/or interventional cardiology

  • Participate actively in the Heart Team

  • Include the patient in the decision process regarding the management of the disease (medical vs. PCI vs. CABG)

Assessment tools
  • Direct observation/WBA (e.g. DOPS, Mini-CEX, fieldnotes)

  • CbD (case-based discussion)/EbD (entrustment-based discussion)

Level of independence
  • 5. Able to teach (no supervision)

Description

Timeframe: from diagnosis of a chronic coronary syndrome until effective treatment or referral

 

Setting: outpatient setting, inpatient setting, and emergency department

 

Including:

 

performance and interpretation of basic diagnostic modalities

 

interpretation of additional diagnostic modalities

 

medical management

 

secondary prevention

 

indication for coronary angiography and/or revascularization strategies

 

Excluding: performing interventional or surgical therapy

CanMEDS roles
  • Medical expert

  • Communicator

  • Collaborator

  • Health advocate

Knowledge
  • Outline the epidemiology of and risk factors for chronic coronary syndromes

  • Describe the molecular and cellular biology of chronic coronary disease

  • Outline the essential features of normal coronary physiology

  • Describe the pathophysiology of myocardial ischaemia, including stunning, hibernation, and viability

  • Describe the events that precipitate angina

  • Discuss the prognosis of chronic coronary syndromes

  • Describe the indications for utilization of specific diagnostic procedures including rest ECG ambulatory ECG, stress test in its different modalities, echocardiography, cardiac computed tomography angiography, cardiac magnetic resonance imaging (MRI), and invasive coronary angiography

  • Analyse the interpretation of non-invasive tests based on Bayes’ theorem

  • Discuss the interpretation of invasive tests

  • Describe medical therapy of chronic stable angina

  • Consider the indications for revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) and the factors that favour one approach over the other

  • Discuss the importance of co-morbidities in the management and prognosis of chronic coronary syndromes

Skills
  • Take a relevant history and perform an appropriate clinical examination

  • Incorporate risk stratification to planning the individual management strategy

  • Identify and treat risk factors for coronary artery disease including lifestyle modification

  • Utilize appropriate therapies for secondary prevention (see specific EPAs) and myocardial ischaemia

  • Manage arrhythmias associated with chronic coronary syndromes

  • Select appropriate patients for referral for revascularization by PCI or CABG

  • Make recommendations on the need for diagnostic tests during follow-up

  • Perform and interpret basic diagnostic modalities and manage emergencies occurring during the test (see specific EPAs)

  • Assess and manage co-morbidities with the help of other specialists

Attitudes
  • Support the Heart Team and, where appropriate, other physicians

  • Maintain consistent adherence to agreed evidence-based protocols in collaboration with off-site interventional cardiologists and cardiac surgeons in the absence of on-site cardiac surgery and/or interventional cardiology

  • Participate actively in the Heart Team

  • Include the patient in the decision process regarding the management of the disease (medical vs. PCI vs. CABG)

Assessment tools
  • Direct observation/WBA (e.g. DOPS, Mini-CEX, fieldnotes)

  • CbD (case-based discussion)/EbD (entrustment-based discussion)

Level of independence
  • 5. Able to teach (no supervision)

Description

Timeframe: from diagnosis of a chronic coronary syndrome until effective treatment or referral

 

Setting: outpatient setting, inpatient setting, and emergency department

 

Including:

 

performance and interpretation of basic diagnostic modalities

 

interpretation of additional diagnostic modalities

 

medical management

 

secondary prevention

 

indication for coronary angiography and/or revascularization strategies

 

Excluding: performing interventional or surgical therapy

CanMEDS roles
  • Medical expert

  • Communicator

  • Collaborator

  • Health advocate

Knowledge
  • Outline the epidemiology of and risk factors for chronic coronary syndromes

  • Describe the molecular and cellular biology of chronic coronary disease

  • Outline the essential features of normal coronary physiology

  • Describe the pathophysiology of myocardial ischaemia, including stunning, hibernation, and viability

  • Describe the events that precipitate angina

  • Discuss the prognosis of chronic coronary syndromes

  • Describe the indications for utilization of specific diagnostic procedures including rest ECG ambulatory ECG, stress test in its different modalities, echocardiography, cardiac computed tomography angiography, cardiac magnetic resonance imaging (MRI), and invasive coronary angiography

  • Analyse the interpretation of non-invasive tests based on Bayes’ theorem

  • Discuss the interpretation of invasive tests

  • Describe medical therapy of chronic stable angina

  • Consider the indications for revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) and the factors that favour one approach over the other

  • Discuss the importance of co-morbidities in the management and prognosis of chronic coronary syndromes

Skills
  • Take a relevant history and perform an appropriate clinical examination

  • Incorporate risk stratification to planning the individual management strategy

  • Identify and treat risk factors for coronary artery disease including lifestyle modification

  • Utilize appropriate therapies for secondary prevention (see specific EPAs) and myocardial ischaemia

  • Manage arrhythmias associated with chronic coronary syndromes

  • Select appropriate patients for referral for revascularization by PCI or CABG

  • Make recommendations on the need for diagnostic tests during follow-up

  • Perform and interpret basic diagnostic modalities and manage emergencies occurring during the test (see specific EPAs)

  • Assess and manage co-morbidities with the help of other specialists

Attitudes
  • Support the Heart Team and, where appropriate, other physicians

  • Maintain consistent adherence to agreed evidence-based protocols in collaboration with off-site interventional cardiologists and cardiac surgeons in the absence of on-site cardiac surgery and/or interventional cardiology

  • Participate actively in the Heart Team

  • Include the patient in the decision process regarding the management of the disease (medical vs. PCI vs. CABG)

Assessment tools
  • Direct observation/WBA (e.g. DOPS, Mini-CEX, fieldnotes)

  • CbD (case-based discussion)/EbD (entrustment-based discussion)

Level of independence
  • 5. Able to teach (no supervision)

Description

Timeframe: from diagnosis of a chronic coronary syndrome until effective treatment or referral

 

Setting: outpatient setting, inpatient setting, and emergency department

 

Including:

 

performance and interpretation of basic diagnostic modalities

 

interpretation of additional diagnostic modalities

 

medical management

 

secondary prevention

 

indication for coronary angiography and/or revascularization strategies

 

Excluding: performing interventional or surgical therapy

CanMEDS roles
  • Medical expert

  • Communicator

  • Collaborator

  • Health advocate

Knowledge
  • Outline the epidemiology of and risk factors for chronic coronary syndromes

  • Describe the molecular and cellular biology of chronic coronary disease

  • Outline the essential features of normal coronary physiology

  • Describe the pathophysiology of myocardial ischaemia, including stunning, hibernation, and viability

  • Describe the events that precipitate angina

  • Discuss the prognosis of chronic coronary syndromes

  • Describe the indications for utilization of specific diagnostic procedures including rest ECG ambulatory ECG, stress test in its different modalities, echocardiography, cardiac computed tomography angiography, cardiac magnetic resonance imaging (MRI), and invasive coronary angiography

  • Analyse the interpretation of non-invasive tests based on Bayes’ theorem

  • Discuss the interpretation of invasive tests

  • Describe medical therapy of chronic stable angina

  • Consider the indications for revascularization by percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) and the factors that favour one approach over the other

  • Discuss the importance of co-morbidities in the management and prognosis of chronic coronary syndromes

Skills
  • Take a relevant history and perform an appropriate clinical examination

  • Incorporate risk stratification to planning the individual management strategy

  • Identify and treat risk factors for coronary artery disease including lifestyle modification

  • Utilize appropriate therapies for secondary prevention (see specific EPAs) and myocardial ischaemia

  • Manage arrhythmias associated with chronic coronary syndromes

  • Select appropriate patients for referral for revascularization by PCI or CABG

  • Make recommendations on the need for diagnostic tests during follow-up

  • Perform and interpret basic diagnostic modalities and manage emergencies occurring during the test (see specific EPAs)

  • Assess and manage co-morbidities with the help of other specialists

Attitudes
  • Support the Heart Team and, where appropriate, other physicians

  • Maintain consistent adherence to agreed evidence-based protocols in collaboration with off-site interventional cardiologists and cardiac surgeons in the absence of on-site cardiac surgery and/or interventional cardiology

  • Participate actively in the Heart Team

  • Include the patient in the decision process regarding the management of the disease (medical vs. PCI vs. CABG)

Assessment tools
  • Direct observation/WBA (e.g. DOPS, Mini-CEX, fieldnotes)

  • CbD (case-based discussion)/EbD (entrustment-based discussion)

Level of independence
  • 5. Able to teach (no supervision)

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