84635 - Cardiovascular System Pathophysiology -

Learning outcomes

At the end of the course the student will have acquired the knowledge of the basic mechanisms of the pathophysiology and the clinic of the main cardiovascular diseases. The fundamentals of the main diagnostic methods and the most recent surgical and interventional cardiology techniques will also be explained.

Course contents

Introduction to diseases of the cardiovascular system.

Clinical and instrumental cardiology semeiotics: medical history, symptoms, signs and physical examination, laboratory tests of cardiovascular interest, Holter-pressure, ECG, ECG-Holter, non-invasive provocative tests for myocardial ischemia (stress test, myocardial scintigraphy), echocardiography, MRI, CT scan, coronary angiography and invasive tests for vessel wall imaging and flow study. For each instrumental investigation, it is important to know the benefits, limits and contraindications in order to understand the indication for its correct/optimal use.

Chronic Coronary Syndromes: Definition. Epidemiology. Etiology and pathogenesis (atherosclerosis and risk factors). Typical and atypical ischemic chest pain. Differential diagnosis of chest pain. Anginal 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.

Acute Coronary Syndromes: Definition. Epidemiology. Etiology and pathogenesis. Classifications (anatomopathological, clinical, ECG-graphic).

Unstable angina and acute myocardial infarction without ST-segment elevation: symptoms and signs, ECG, laboratory tests and instrumental investigations; therapeutic goals; medical therapy; revascularization interventions. Classification of unstable angina.

Acute ST-elevation myocardial infarction: symptoms and signs, ECG, laboratory tests and instrumental investigations; therapeutic goals; supportive medical therapy of the acute phase; myocardial reperfusion and percutaneous revascularization. Complications of acute myocardial infarction. Prognosis and risk stratification of adverse events. Long-term therapy and secondary prevention.

Arrhythmias: General classification and mechanisms. Supraventricular tachycardias (definition and classification): (1) sinus tachycardia; (2) supraventricular ectopic beats; (3) atrial fibrillation (pathophysiology, symptoms, ECG features, comorbidities, natural history, complications and risk stratification, medical management, ablation, and cardioversion); (4) atrial flutter (characteristics, complications and therapy); (5) Wolff-Parkinson-White syndrome; (6) nodal reentrant tachycardia; (7) ectopic atrial tachycardia. Ventricular tachycardias (definition and classification, ECG features), (8) ventricular fibrillation; (9) Tip twist. Bradycardias and conduction blocks (definition, classification, and ECG picture): (1) sinus bradycardia; (2) sick sinus syndrome; (3) atrio-ventricular blocks; (4) bundle branch blocks. Indications and operation of pacemakers and implantable defibrillators. Transcatheter ablation.

Valvulopathies: (1) Aortic valve diseases: Classification, definitions, etiologies, pathophysiology, symptoms, aortic murmurs and other clinical signs, instrumental diagnostics, 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.

(2) Mitral valve diseases: Classification, definitions, etiologies, pathophysiology, symptoms, mitral murmurs and other clinical signs, instrumental diagnostics, 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.

Cardiomyopathies: Definition and classification: primary and secondary forms. Etiology, genetic aspects and molecular biology. Clinical picture. Instrumental examinations. Diagnostic criteria. Natural history and complications. Risk stratification. Treatment. Arrhythmogenic cardiomyopathies

Readings/Bibliography

Core Curriculum. Cardiologia. A. Branzi, F. Picchio. McGraw Hill Education

Linee guida cardiologiche - Società Europea di Cardiologia [https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines]

Malattie del cuore di Braunwald - Trattato di medicina cardiovascolare [https://sol.unibo.it/SebinaOpac/query/braunwald%20s%20heart%20disease%20a %20textbook%20of%20cardiovascular%20medicine?context=catalogo]

Teaching methods

Interactive lectures

Assessment methods

Assessment test

Teaching tools

Teaching slides

Office hours

See the website of Tullio Palmerini