10 ECTS credits
300 h study time
Offer 1 with catalog number 6021993FNR for all students in the 1st and 2nd semester at a (F) Master - specialised level.
Echocardiograph (transthoracic and transesophageal echocardiograph): level C
Stress echocardiograph: level A
Nuclear techniques: level A
Cardiac CT: level A
Cardiac MRI: level A
Heart catheterization
Knowledge of the side-effects of antibodies and their prevention
Arterial punctures: level C
Care for an arterial catheter, care and monitoring of the puncture location after the procedure
Right heart catheterization
Left heart catheterization and coronarography: level B
Skills: interpretation of pressure curves, flow measurements, resistance measurements and coronary angiograms
Percutaneous therapeutic interventions to the coronaries, heart valves, implantation of intracardiac devices (occlude devices, heart valves…): level A
Cardiovascular genetics
Knowledge and insights in the most common genetically transmissible cardiovascular afflictions
Knowledge on genetic and molecular aspects of atherosclerosis, heart failures and rhythm disorders in the prospect of individualized therapy
Clinical pharmacology
Knowledge and policy skills in administering cardiovascular medicines in accordance with the applicable guidelines
Thorough knowledge on the pharmacology of anti-anti-aggregants and anti-coagulation, thrombolytics, ACE-I, ARB’s, aldosterone antagonists, beta AR antagonists, calcium antagonists, anti-arrhythmics, sinus node inhibitors, diuretics, lipid-lowering medication, nitrates, vasodilators, digitalis, inotropics, cardiotoxic medications and newer cardiovascular medications.
Knowledge on the interaction of cardiovascular medications
Scientific literature
Knowledge, insights and interpretation of clinical cardiovascular studies, including biostatic aspects
Knowledge of the applicable guidelines and of “Evidence-Based Medicine”
Cardiovascular prevention and risk stratification
Thorough knowledge and policy skills in primary and secondary cardiovascular prevention
Actively contribute to global initiatives to lower the prevalence of cardiovascular diseases (VLIR – specialist in cardiology – May 2008)
Sensitize the patient and population for the importance of cardiovascular prevention
Stress the lifestyle improvements for the prevention of atherosclerosis
Arterial hypertension
Knowledge on the pathogenesis of primary and secondary hypertension
Diagnosis and treatment of cardiovascular complications of diabetes mellitus
Detection and treatment of organ damage via arterial hypertension
Diabetes and the heart
Prevention of diabetes mellitus and increasing insulin resistance (metabolic syndrome)
Diagnosis and treatment of cardiovascular complications of diabetes mellitus
Experience with multidisciplinary approach of diabetes patients
Acute coronary syndromes
Knowledge of the pathogenesis of the ACS
Thorough knowledge and policy skills of the diagnosis and treatment of the ACS in accordance with the applicable guidelines. This concerns the STEMI, the NSTEMI and the unstable angora pectoris
The following policy skills are assumed:
Prehospital approach of a patient with acute thoracic pain
Diagnostics and early pharmacotherapy of the ACS
Reperfusion strategy: administer fibrinolysis, reference for primary PTCA
Diagnosis and handling of the cardiovascular complications of the ACS and of the reperfusion treatments
Detect and treat heart failures and residual coronary ischemia
Risk stratification, monitoring and treatment of the patients after an ACS
Chronic ischemic heart suffering
Knowledge of the pathogenesis of chronic ischemic heart suffering
Evaluation, guidance and treatment of coronary patients, in accordance with the applicable guidelines
Primary cardiomyopathies
Knowledge of the pathogenesis of the primary cardiomyopathies
Diagnosis, risk stratification and treatment of restrictive, hypertrophic and dilatated cardiomyopathies
Knowledge of the genetic determination of particular cardiomyopathies, in stapling diseases, in toxic cardiac influences
Cooperation with genetically educated colleagues for the guidance and counseling of patients and their families
Pericardial afflictions
Diagnosis, evaluation and treatment of the fibrinous, exudative and constrictive pericarditis
Perform a diagnostic and evacuating pericardial puncture: level B
Cardiac tumors
Diagnosis and evaluation of primary and secondary tumors of the heart
Congenital heart afflictions in children and adults
Recognize simple, complex and post-operative congenital heart afflictions in the prospect of a referral to a reference center
Monitoring simple congenital heart afflictions (ASD, VSD, afflictions to the aorta valve, pulmonary valve) in cooperation with a reference center
Pregnancy and heart afflictions
Knowledge of the hemodynamic changes and the echocardiographic findings in pregnant women
Knowledge on the use of cardiovascular medication in pregnant women
Counseling and guiding women with a heart affliction regarding the pregnancy
Guidance of a pregnancy in a woman with heart affliction, in cooperation with a reference center
Afflictions to the heart valves
Knowledge of the pathogenesis of the valve afflictions
Clinical and echocardiographic description of afflictions to the heart valves, their hemodynamic reflection and complications
Thorough knowledge of the operative indications in accordance with the applicable guidelines
Clinical and echocardiographic evaluation of surgically corrected heart valves, bio-prostheses, homografts and artificial grafts
Infectious endocarditis
Thorough knowledge on the prevention of endocarditis in accordance with the applicable guidelines
Provide advice to patients and other health care providers regarding the prevention of endocarditis
Diagnosis, risk stratification and treatment of an endocarditis in close cooperation with a cardiosurgical center
Heart failures
Thorough knowledge of the pathogenesis of heart failures
Prevention of heart failures in patients with damage to the heart function
Diagnosis and differential diagnosis of the symptoms of heart failures
Fine-tuning of heart failures with imaging, effort tests, detect arrhythmia and other complications
Treatment of heart failures in accordance with the applicable guidelines. This treatment comprises:
Pharmacotherapy
Adjustment of diet and lifestyle
Detect indications for device treatment (CRT, ICD) a
nd cardiosurgical corrections
Knowledge of the multidisciplinary approach of patients with heart failures
Pulmonary hypertension
Knowledge of the causes and pathogenesis of pulmonary hypertension
Recognize and document pulmonary hypertension
Treatment and monitoring of patients with serious pulmonary hypertension in cooperation with a reference center
Cardiac revalidation
Knowledge of the principles of revalidation of heart patients
Knowledge of the functioning in a multidisciplinary cardiac revalidation program
Indication statement for multidisciplinary cardiac revalidation in the field of coronary afflictions, heart failures, peripheral arterial suffering
Effort physiology
Perform and interpret effort tests in Bayesian logics, level C
Integration of imaging with effort tests, see also (1)
Evaluation of the effort tolerance, transactions and interpretations of the analysis of respiratory gases during effort, level B
Arrhythmia
Thorough knowledge of the pathogenesis, the clinical appearance and the electrocardiographic diagnostics of the various rhythm- and conductance disorders
Evaluation of a patient with palpitations
Treatment of a patient with rhythm- and conductance disorders according to the applicable guidelines
Pharmacotherapy
Electrical and pharmacological reconversion, level C
Indication of pacemaker implantation, ICD implantation
Indication for ablation therapy
Implantation of a temporary pacemaker, level C
Implantation of a permanent pacemaker, level B
Monitoring of patients with a pacemaker, level C
Monitoring of a patient with an internal cardiac defibrillator in cooperation with a reference center
Atrial fibrillation
Knowledge of the pathogenesis of the various forms of atrial fibrillation
Cardiological fine-tuning of a patient with a VKF
Treatment of a patient with VKF
Prevention of thrombo-embolic complications
Recovery of sinusoidal rhythm
Control of the ventricular response
Referral of patients that qualify for an ablation of VKF for the implantation of a device
Syncope
Knowledge of the pathogenesis of syncope
Diagnosis and differential diagnosis of syncope
Cardiovascular elaboration of the complaint, including the Tilt test, level B
Guidance and treatment of the patient with recurrent syncopes
Sudden cardiac death and reanimation
Thorough knowledge and skills in the basic and advanced reanimation techniques
Knowledge of the pathogenesis and differential diagnosis of sudden cardiac death
Risk stratification after reanimation, fine-tuning and indication statement for implantation for a defibrillator
Prevention of sudden cardiac death via referral to high-risk patients for further fine-tuning and implantation of a defibrillator
Afflictions of the large blood vessels and cardiovascular traumata
Knowledge of the aneurismata & dissection of the aorta and the large blood vessels
Knowledge of the genetics and cardiovascular deviations in the syndrome of Marfan and associated afflictions
Knowledge and diagnosis of traumatic afflictions to the heart and the large blood vessels
Cooperation with interventional cardiologists, cardiovascular surgeons and radiologists
Peripheral arterial suffering
Knowledge of the epidemiology, pathogenesis and prevention of peripheral arterial suffering
Clinical evaluation of the patient with peripheral arterial suffering
Non-invasive fine-tuning by means of duplex echograph (level B0 and other imaging techniques
Cooperation with interventional cardiologists, vascular surgeons, radiologists and endocrinologists
Phlebothrombosis and pulmonary embolies
Thorough knowledge and skills in the prevention, diagnosis and treatment of superficial venous thromboses, deep venous thromboses and pulmonary embolies
Knowledge and skills in the indication statement for fibrinolytic or surgical interventions
Knowledge and skills in the treatment of anti-thrombotics, including fibrinolysis
Overview of technical skills the cardiologist is expected to possess after completing the education:
The cardiologist is to perform the following activities autonomously:
Anamnesis and clinical examination in patients with heart diseases
Collection and interpretation of the electrocardiogram in rest and after effort
Recording and interpretation of a transthoracic and transesophageal echocardiograph
Recording and interpretation of long-term registration of the cardiac rhythm (holter monitoring) and blood pressure
Puncture of arteries and deep venous structures
Pleura punctures
Recording and interpretation of pressures in the heart
Placement of a temporary pacemaker
External electric cardioversion and defibrillation of arrhythmia
Reanimation in sudden death (basic and advanced life support)
Review of a pacemaker
The cardiologist requires practical experience in the following examinations, but not necessarily as autonomous operator:
Recording and interpretation of a diagnostic coronarography and ventriculography of the left ventricle
Implantation of a pacemaker
Review of a defibrillator or device for cardiac resynchronization therapy
Ergo-spirometrics
Placement and setting up an intra-aortal balloon pump
Pericardial puncture
Thorax drainage
Doppler/duplex of the blood vessels
The cardiologist knows the following techniques and is able to explain them in understandable languages to the patients. In case of application, he/she is able to make a choice between the various techniques and interpret the results of these techniques and assess their effectivity towards the treatment of his/her patients:
Stress echocardiograph
Examinations used in the non-invasive risk stratification of life-threatening arrhythmias that may lead to sudden death, e.g. heart rhythm variability, late potentials electrocardiograph, T-wave alternans…
Electrophysiological examination and ablation of arrhythmias
Implantation of a defibrillator
Implantation of a device used for cardiac resynchronization therapy
Therapeutic percutaneous coronary interventions
Endomyocardial biopsy collection
Nuclear imaging of the heart: ventriculography, SPECT, PET
Cardiac CT-scan
Cardiac KST
The cardiologist is expected to update his/her knowledge on and experience with these techniques using the present practical standards and guidelines
WORKING METHODS
The final objectives are mainly met in practice via:
Bedside teaching
Sessions for technical skills (e.g. supra)
Supervised consultation radiology (and hypertension)
OLR 2: Has acquired the skills, inherent to the specialism, and applies these correctly (M).
OLR 17: Keeps further developing and improving own skills (M).
The final grade is composed based on the following categories:
Other Exam determines 100% of the final mark.
Within the Other Exam category, the following assignments need to be completed:
Portfolio with 3-monthly performance interview (4x/year, 25% per evaluation)
PASS/FAIL
This offer is part of the following study plans:
Master of Specialist Medicine: Cardiology (only offered in Dutch)