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- 34th AGM & 2025 ASM
Cardiology
Draft proposed by Dr Simon To, Dr Sabrina Tsao, Dr NC Fong
Reviewed by Dr Stephen Chan, Dr Annie Fok
Essential Skills
Domain 1 - Professional Values & Behaviour
Domain 2 - Communication
Domain 4 - Patient management
Domain 5 - Health promotion & Illness prevention
Additional desirable skills are listed in each proposal. These recommended skills are to be acquired as opportunity arises.
Download Syllabus (28 November 2023)
VIEW another syllabus
Basic Training
Heart Failure
- Pathophysiology of heart failure
- Clinical manifestation and recognition
- Pharmacology of diuretics and anti-failure medications
Heart murmur
- Differentiating pathological murmurs
- Formulate differential diagnoses based on murmur characteristics
- Common forms of innocent murmur
Chest pain
- Differentiating cardiac chest pain
- Role and limitations of ECG, cardiac enzymes and treadmill testing
Palpitations, syncope and arrhythmias
- Approach to palpitations
- Approach to diagnosis and management of vasovagal syncope
- Common causes of syncope and recognising red flags
- ECG interpretation and recognition of significant arrhythmias (e.g. SVT, VT, VF, heart block) and channelopathies (e.g. long QT)
- Acute management of SVT, VT, VF and symptomatic bradyarrhythmias
- Diagnostic and therapeutic use of adenosine/ATP
- DC cardioversion and defibrillation
Acyanotic congenital heart disease
Understand the haemodynamics, clinical, radiographic and ECG features, complications and natural history of congenital heart diseases with:
- Left-to-right shunt
- Valvular stenosis
- Valvular regurgitation
Duct dependent lesions and cyanotic heart diseases
Approach and investigations in a cyanotic or collapsed newborn
Understand the haemodynamics and clinical features of congenital heart diseases with:
- Right-to-left shunt, including tetralogy of Fallot
- Common mixing, including transposition of great arteries
- Duct dependent systemic circulation, including coarctation of aorta
- Duct dependent pulmonary circulation, including critical PS/atresia
Pharmacology and monitoring of medications used to maintain ductal patency
Differentiating non-cardiac causes of a cyanotic newborn (e.g. PPHN, respiratory causes)
Coronary artery disease and Kawasaki disease
- Understand the coronary complications in Kawasaki Disease
- Recognise the clinical manifestations and investigation findings in Kawasaki Disease and initiate appropriate treatment
- Identify risk factors for coronary artery disease
- Counselling on lifestyle issues to improve coronary health
Pericardial Diseases and Myocarditis
Understand the clinical manifestations, initial investigations, initial management and indications for referral of
- Pericarditis
- Myocarditis
- Pericardial effusion and cardiac tamponade
Acquired valvular diseases
Recognise the clinical features and indications for referral for:
- Rheumatic fever
- Infective endocarditis
Cardiovascular manifestation of systemic and genetic disorders
Recognise the cardiac involvement in common genetic disorders (e.g. Down, Turner, Noonan, Marfan, Williams and DiGeorge syndrome).
Cardiomyopathy
Recognise the presentation of hypertrophic and dilated cardiomyopathy.
Higher Training
Heart Failure
- Nutritional and feeding support
- Pharmacological treatment of chronic heart failure, drug interactions, monitoring and follow up
- Management of acute heart failure
- Pharmacology of inotropes
- Recognise the indications for referral for mechanical circulatory support (e.g. ECMO)
Heart murmur
- Initiate investigations for heart murmurs and determining urgency of cardiology referral
- Approach to murmur during acute or systemic illnesses
Congenital heart disease
- Interpreting echocardiogram reports and associating them with clinical, radiographic and ECG features
- Understand the indications for treatment and urgency of cardiology referral for congenital heart diseases
- Stabilisation of the cyanotic or collapsed newborn and subsequent transport
- Acute management of a hypercyanotic spell
- Acute management of a pulmonary hypertensive crisis
- Understanding the expansion of adult congenital heart disease and long term issues before they can be transitioned
Arrhythmias
- Understanding ambulatory ECG and treadmill ECG reports
- Approach to common ECG variants and abnormalities (e.g. ectopic beats, neonatal bradycardia, artefacts)
- Pharmacology of common anti-arrhythmics (e.g. beta-blocker) and monitoring
- Recognise indications for cardiology referral for arrhythmias, including those who may benefit from electrophysiology studies and ablation.
- Recognise medication and exercise precautions in patients at risk of arrhythmias and sudden cardiac death (e.g. long QT syndrome)
Coronary artery disease and Kawasaki disease
- Recognise acute complications of Kawasaki disease (e.g. KD shock syndrome, macrophage activation syndrome)
- Recognition of refractory Kawasaki disease
Acquired valvular diseases
- Management of infective endocarditis
- Counseling regarding endocarditis prevention and dental hygiene
Cardiovascular manifestation of systemic and genetic diseases
Recognise the cardiac involvement and indications for cardiology referral in:
- Syndromes with multiorgan involvement (e.g. VACTERL, Alagille, Duchenne muscular dystrophy)
- Inborn errors of metabolism
- Anorexia nervosa
- Rheumatological diseases
Cardiomyopathy
- Initial management in an acute DCM or HCM decompensation
- Recognise patients who may be at risk of secondary cardiomyopathies (e.g. anthracycline toxicity in oncology patients, thalassaemia with iron overload)
Cardiovascular genetics
- Recognise indications for genetic referral in syndromic cardiac diseases, cardiomyopathies and channelopathies
- Interpret reports from genetic services and incorporate them in the overall management of the patient
Desirable skills
Bedside functional echocardiogram to assess cardiac function, chamber sizes and pericardial effusions.
