Module 7: Cardiovascular Disorders

Module Authors

Janice Tramel, NP/PA-C
Testing Coordinator , Primary Care Physician Assistant Program
Department of Family Medicine, Keck School of Medicine
University of Southern California , Los Angeles, CA

Eric Chew, PA-C, RNP
Clinical Instructor, Primary Care Physician Assistant Program
Department of Family Medicine, Keck School of Medicine
University of Southern California, Los Angeles, CA

Tina M. Meyer, PA-C
Clinical Consultant and Adjunct Professor
Western University of Health Sciences, Pomona, CA

Review Concepts

By the end of this Review Concept you should be able to:

• Describe the epidemiology, etiology, and pathogenesis of hypertension
• Differentiate essential, secondary and malignant hypertension
• Describe the clinical presentation of hypertension
• Describe end organ damage that can be caused by hypertension
• Explain the classification system commonly utilized to stage blood pressure problems
• List risk factors for hypertension.
• Outline procedures for the diagnostic workup and clinical management of hypertension.
• Describe the agents most commonly utilized to treat hypertension

By the end of this Review Concept you should be able to:

• Define ischemic heart disease
• Explain the pathophysiology of heart disease and its progression
• List major risk factors for coronary artery disease
• Differentiate the clinical presentations of stable angina, unstable angina, Prinzmetal angina, and acute myocardial infarction
• Outline pharmacologic modalities for treating ischemic coronary artery disease

By the end of this Review Concept you should be able to:

• Define congestive heart failure
• Differentiate between systolic and diastolic dysfunction as etiologies of CHF
• Understand basic pathophysiology of left-sided versus right-sided CHF
• Explain the importance of LV ejection fraction
• Cite appropriate diagnostic work-up of patients with CHF
• Compare and contrast the different classifications in the New York Heart Association Functional Classification List

By the end of this Review Concept you should be able to:

• Describe common non-pharmacologic interventions for the treatment of congestive heart failure (CHF)
• List the pharmacotherapeutic agents utilized in treating CHF
• Differentiate treatment modalities for systolic versus diastolic CHF
• Describe the effects of pharmacotherapeutic agents in the elderly
• Outline procedures for the diagnostic workup and clinical management of hypertension.

By the end of this Review Concept you should be able to:

• Describe the course of rheumatic fever and its consequences.
• Differentiate the etiology, presentation, diagnostic workup and clinical management of endocarditis, pericarditis and myocarditis.
• Outline treatment modalities for infectious heart disease.

By the end of this Review Concept you should be able to:

• Define cardiac arrhythmia.
• Describe the epidemiology and pathogenesis of common arrhythmias such atrial fibrillation or ventricular tachycardia.
• Differentiate the pathophysiology and clinical presentation of arrhythmias caused by impulse formation and impulse conduction
• Differentiate between atrial and ventricular arrhythmias.
• Outline procedures and tests used in the diagnostic workup of the arrhythmic patient.
• Describe pharmacological and nonpharmacological interventions used in the management of atrial fibrillation, ventricular tachycardia, and premature ventricular contractions.
• Compare and contrast the effectiveness and safety of various medications used in managing cardiac arrhythmias

By the end of this Review Concept you should be able to:

• Describe the different lesions associated with congenital heart disease.
• List the common risk factors for congenital heart disease.
• Differentiate the pathophysiology that leads to cyanotic and acyanotic heart defects.
• Describe the epidemiology, clinical presentation and management of atrial and ventricular septal defects
• Describe the epidemiology, clinical presentation and management of patent ductus arteriosus.
• Describe the epidemiology, clinical presentation and management of tetralogy of Fallot.
• Describe the epidemiology, clinical presentation and management of coarctation of the aorta.

By the end of this Review Concept you should be able to:

• Explain the pathogenesis and pathophysiology of heart murmurs.
• Describe factors that affect the intensity or loudness of a given heart murmur.
• Describe a classification scheme used to rate the intensity of a given murmur.
• Describe the epidemiology, pathogenesis, pathophysiology and clinical presentation of the following valvular disorders:
  • Aortic stenosis
  • Aortic regurgitation
  • Mitral stenosis
  • Mitral regurgitation
  • Mitral valve prolapse
• Outline procedures and indicators that are relevant in the diagnostic workup and clinical management of the above disorders..

By the end of this Review Concept you should be able to:

• Differentiate the types of cardiomyopathies and their effects on the myocardium.
• Describe the clinical presentation and management of each type of cardiomyopathy discussed.
• Describe the epidemiology, pathophysiology, and clinical presentation of cardiac tamponade.
• Outline procedures and indicators in the diagnostic workup and clinical management of patients with cardiac tamponade.
• List etiologies and risk factors for sudden cardiac death syndrome
• Describe the pathophysiological relationship between ventricular tachycardia and sudden cardiac death
• Outline procedures in the diagnostic workup and clinical management of patients with a high risk of sudden cardiac death.

By the end of this Review Concept you should be able to:

• Differentiate the major types of peripheral vascular disorders.
• Explain the clinical association between dyslipidemia, atherosclerosis and coronary artery disease.
• Describe the clinical manifestations and diagnostic indicators of hyperlipidemia.
• Describe the risk factors and clinical management of hyperlipidemia.
• Differentiate the clinical presentation and management of arteriosclerosis, thromboangiitis, and Raynaud's Disease
• Describe the epidemiology, clinical presentation, diagnostic workup and clinical management of thrombophlebitis and deep venous thrombosis.
• Describe etiology, common sites, clinical consequences and management of aortic aneurysms.

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