08957 - Cardiovascular Diseases

Academic Year 2022/2023

  • Docente: Carmine Pizzi
  • Credits: 4
  • SSD: MED/11
  • Language: Italian
  • Moduli: Carmine Pizzi (Modulo 1) Marcello Galvani (Modulo 2) Massimiliano Palazzini (Modulo 3) Tullio Palmerini (Modulo 4)
  • Teaching Mode: Traditional lectures (Modulo 1) Traditional lectures (Modulo 2) Traditional lectures (Modulo 3) Traditional lectures (Modulo 4)
  • Campus: Forli
  • Corso: Single cycle degree programme (LMCU) in Medicine and Surgery (cod. 5709)

Learning outcomes

The course aims to provide the student with the essential elements for the knowledge of the main diseases and syndromes involving the cardiovascular system with the acquisition of a correct clinical methodological approach. At the end of the course the student will have learned the basics of the main pathologies of cardiovascular interest. The student will have the knowledge necessary to recognize the type and severity of a pathology through the evaluation of symptoms, clinical signs and laboratory and instrumental tests. He will also have the elements to perform a risk stratification and to identify therapeutic objectives in order to cure or slow the progression of diseases or prevent its complications.

Course contents

nital heart disease

Chronic coronary syndromes. Definition. Epidemiology. Etiology and pathogenesis (atherosclerosis and risk factors). Typical and atypical chest pain. Differential diagnosis of chest pains. Anginous equivalents. ECG and other instrumental investigations. Diagnosis and classification. Therapeutic goals. Medical therapy. Revascularization interventions. Risk stratification. Therapeutic goals for the prevention of major cardiovascular events. Gender differences.

Acute coronary syndromes. Definition. Epidemiology. Etiology and pathogenesis. Classifications (anatomic, clinical, ECG). Unstable angina and NSTEMI: symptoms and signs, ECG, laboratory tests and imaging; therapeutic goals; medical therapy; revascularization interventions. Classification of unstable angina. STEMI: symptoms and signs, ECG, laboratory tests and imaging; therapeutic goals; supportive therapy of the acute phase; reperfusion and percutaneous interventions. No-reflow phenomenon. Complications of acute myocardial infarction. Prognosis and risk stratification.Long-term therapy. Secondary prevention. Fourth universal definition of acute myocardial infarction. Acute myocardial infarction without obstructive coronary artery disease. Gender differences.

Heart failure. Definition, etiology (cardiac and extra-cardiac causes), pathophysiology, symptoms and signs, laboratory and imaging. Clinical pictures: acute and chronic heart failure; predominantly left heart failure, predominantly right heart failure, congestive heart failure, heart failure with preserved ejection fraction, high flow heart failure. NYHA classification. Natural history of the disease. Therapeutic goals. Initial medical therapy. Advanced medical therapy and resynchronization. Prognosis. Indications for transplantation. Gender differences.Definition, etiology, symptoms and signs, laboratory and instrumental tests in acute pulmonary edema. Therapeutic goals. Medical therapy for acute pulmonary edema. Cardiogenic shock.

Supraventricular arrhythmias Supraventricular ectopic beats. Atrial fibrillation: definition, epidemiology, etiology, classification, ECG, natural history. Risk stratification. Medical therapy, ablation and cardioversion. Long-term management. Atrial flutter; Wolff-Parkinson-White syndrome; Paroxysmal supraventricular tachycardia.

Ventricular arrhythmias Ventricular ectopic beats. Ventricular tachycardias. Ventricular fibrillation.

Bradyarrhythmias Sick sinus syndrome. Atrioventricular blocks. Left and right bundle branch blocks.

Pulmonary embolism Definition, epidemiology, etiopathogenesis (Virchow triad and predisposing factors), symptoms and signs, blood tests, ECG and imaging. Clinical probability assessment. Classification of clinical severity. Prognostic evaluation. Therapy of the acute phase. Long-term therapy.

Pulmonary hypertension Epidemiology, definition, classification, etiology, pathophysiology, risk factors. Clinical pictures. Lab and other diagnostic tests. Treatment goals.

Aortic valve diseases. Classification, definitions, etiologies, pathophysiology, symptoms, aortic murmurs and other clinical signs, imaging, natural history and prognosis. Medical therapy: prevention of complications, optimization of hemodynamics. Invasive treatment: indications for interventional therapy, indications for surgical therapy. Medical management after invasive treatment.

Mitral valve diseases. Classification, definitions, etiologies, pathophysiology, symptoms, mitral murmurs and other clinical signs, imaging, natural history and prognosis. Medical therapy: prevention of complications, optimization of hemodynamics. Invasive treatment: indications for interventional therapy, indications for surgical therapy. Medical management after invasive treatment.

Tricuspidal regurgitation. Etiology, clinical and instrumental recognition, therapy.

Pericardial and myocardial diseases Etiology, pathophysiology. Clinical pictureS (signs, symptoms, laboratory tests and instrumental diagnostics): myocarditis, acute pericarditis, chronic pericarditis, recurrent pericarditis, constrictive pericarditis, pericardial effusion and cardiac tamponade. Differential diagnosis. Pericardiocentesis. Treatment goals.

Endocarditis Definition, epidemiology, pathogenesis, predisposing factors, infectious agents, symptoms and clinical signs. Classification. Lab and other diagnostic exams. Diagnosis criteria. Natural history and complications. Medical therapy. Surgical therapy: indications and strategies. Prophylaxis of infectious endocarditis.

Cardiomyopathy Definition and classification: primitive and secondary forms. Etiology, genetic aspects and molecular biology. Clinical picture. Diagnostic criteria. Natural history and complications. Risk stratification. Treatment.

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Readings/Bibliography

  • Updated teaching material, will be made available on the platform for teaching support service:Virtuale

  • European Society of Cardiology Clinical Practice Guidelines [http://www.escardio.org/Guidelines/Clinical-Practice-Guidelines]
  • Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine [https://sol.unibo.it/SebinaOpac/query/braunwald%20s%20heart%20disease%20a%20textbook%20of%20cardiovascular%20medicine?context=catalogo]

Teaching methods

  • Slides presentation supported lectures with discussion breaks
  • Teaching resources and material: teaching material presented in class will be made available online on the platform for teaching support service:Virtuale

Assessment methods

The final exam will be an oral exam consisting of a minimum of two, or possibly more questions on the obligatory readings (books and lecture notes) focusing on the educational objectives and topics of the course of Cardiovascular and Respiratory Apparatus Diseases (I.C.).

Teaching tools

  • Projector, PC
  • Platform for teaching support service: Insegnamenti online - IOL

Office hours

See the website of Carmine Pizzi

See the website of Marcello Galvani

See the website of Massimiliano Palazzini

See the website of Tullio Palmerini