Non-Invasive Cardiac Physiology

Learning Outcomes

Learning Outcomes

Having successfully completed this module you will be able to:

• Become informed recipients of research evidence in healthcare science by critically appraising professional journals and associated literature using established appraisal tools
• Recognise and evaluate limitations of non-invasive investigations.
• Interpretation of non-invasive diagnostic investigations.
• Evaluate the need for calibration and quality assurance for all measurements undertaken in Cardiac Physiology
• Explain the principles of a range of routine non-invasive diagnostic cardiac investigations used to detect and quantify cardiac disease, and compare and contrast each modality. a) 12 lead Clinical Electrocardiography b) Ambulatory electrocardiography application and analysis c) Blood pressure measurement d) Ambulatory blood pressure monitoring & analysis e) Cardiac stress testing procedures f) Transthoracic echocardiography

In this module students will build on Year 1 learning and begin detailed learning that underpins the routine practical techniques.

Clinical Electrocardiography

• Characteristics of recording equipment
• Components and functions
• Settings and adjustments made based on patient category
• Recommended measurement technique

Recognition of life threatening arrhythmias

• Ventricular fibrillation
• Asystole
• Ventricular tachycardia

Recognition of:

• Common arrhythmias:
• Sinus arrhythmia
• Sinus bradycardia
• Sinus tachycardia
• Atrial fibrillation
• Atrial ectopics
• Atrioventricular conduction blocks
• Ventricular arrhythmias
• The effect of myocardial Infarction and ischaemia on the electrocardiogram

Routine Blood Pressure Measurement

• Principles and limitations of range of recording equipment used to measure blood pressure
• Mercury and aneroid sphygmomanometers
• Electronic Devices including wrist devices
• Device calibration
• Indications for blood pressure measurement
• Factors affecting blood pressure including blood pressure variability and white coat hypertension.
• Recommended measurement technique
• Common errors in blood pressure measurement
• Observer
• Equipment
• Patient
• Cardiac Arrhythmias
• Normal blood pressure ranges
• Definition of hypertension

Ambulatory blood pressure recording

• Characteristics of recording equipment
• Indications
• Contra-Indications
• Recommended measurement technique
• Normal Ranges
• Common problems
• Analysis, presentation and evaluation of results

Ambulatory electrocardiography

• Characteristics of recording equipment
• Indications
• Contra-Indications
• The effect of activity on the circulatory system
• Recommended measurement technique
• Common problems
• Analysis, presentation and evaluation of results

Cardiac stress testing

• Characteristics of recording equipment
• Indications
• Contra-Indications and end-points
• Recommended measurement modality
• Common problems
• Protocols for cardiac stress testing
• The effect of exercise on the heart, lungs and circulation
• ECG and functional changes associated with ischaemic heart disease
• Cardiac arrhythmias and exercise
• Differential diagnosis of cardiac and non-cardiac outcomes

Echocardiography

• Characteristics of ultrasound equipment
• Standard transthoracic imaging windows
• Standard planes and views to image the heart
• Limitations of procedure
• Evaluation of results
• Basic overview of congenital heart disease
• Embryology
• Circulatory changes at birth
• Common abnormalities which may include
• Atrial Septal Defects
• Ventricular Septal Defects
• Patent Ductus Arteriosus
• Coarctation of the Aorta
• Tetralogy of Fallot

Communication skills and team working

Teaching and learning methods

Students will learn by exploring material in seminars and laboratory practicals in conjunction with directed learning. Students will be encouraged to take responsibility for the development of their own learning by utilising a variety of means such as multimedia resources, and the library, and by self-directed development of the study skills necessary to access these resources.

Resources & Reading list

Textbooks

Houghton A (2014). Making Sense of Echocardiography A hands-on guide. CRC Press.

Ellestad, M. (2003). Stress testing: Principles and Practice. Oxford University Press.

Klabunde, R. (2005). Cardiovascular Physiology Concepts. Lippincott Williams & Wilkins.

Guyton, A. (2016). Textbook of Medical Physiology. Elsevier.

Wagner, G. (2007). Marriott's Practical Electrocardiography. Lippincott, Williams & Wilkins.

Conover M (2002). Understanding Electrocardiography. Mosby.

Bonita Anderson (2017). Echocardiography. The Normal Examination and Echocardiographic Measurements.. MGA Graphics.

Huszar, R (2007). Basic Dysrhythmias: Interpretation & management. Mosby.

Bono, R (2008). Braunwald's Heart Disease. Elsevier.

Morris, F. (2008). The ABC of Clinical Electrocardiography. BMJ.

Opie, L. (2004). Heart Physiology: From Cell to Circulation. Lippincott Williams & Wilkins.

Bennett, D. (2013). Cardiac Arrhythmias: Practical Notes on Interpretation and Treatment. Wiley-Blackwell.

Assessment strategy

Both components of the summative assessment must be passed

Formative

This is how we’ll give you feedback as you are learning. It is not a formal test or exam.

Summative

This is how we’ll formally assess what you have learned in this module.

Referral

This is how we’ll assess you if you don’t meet the criteria to pass this module.

Repeat Information

Repeat type: External