Cardiology

Working closely with our cardiologists, primarily on the inpatient consultation service, residents become comfortable in diagnosis and treatment of a full range of cardiac ailments.  Park Nicollet and Methodist Hospital have long been known for high quality cardiovascular care, and we enjoy an excellent working relationship with our group of cardiologists.

The opening of the Park Nicollet Heart and Vascular Center in 2005, adjoined to Methodist Hospital, has brought many innovative services together under one roof:

• Heart rhythm testing and management
• Stress testing
• Heart imaging
• Angioplasty, stenting and other invasive procedures
• Cardiac surgery
• Cardiac rehabilitation

Cardiology Rotation Teaching Module

Rotational Goal
Residents will gain an understanding of cardiology and cardiac-associated diseases and conditions which are frequently present in a general family medicine practice and may be further referred to cardiologists for evaluation and treatment.

Rotational Objectives
By the end of the cardiology rotation, residents will be able to demonstrate competence in the diagnosis and treatment of cardiac conditions as follows: 

(A) Patient Care
Through patient care experience gained as part of the cardiology rotation, when further presented with patients in the family medicine clinic or inpatient setting, residents will be able to:

• Accurately demonstrate taking an appropriate cardiac history to include assessment of significance and severity of symptoms, medication and other treatment history, and likelihood of alternate diagnoses.
• Formulate appropriate management plans for patients with cardiovascular diseases, including use of medication, laboratory testing, and application of noninvasive and invasive cardiac testing results.
• Assess risk of cardiovascular disease in asymptomatic outpatients, based on risk factor analysis and other appropriate modalities, and provide appropriate guidance and education regarding therapeutic lifestyle modification and medication management for primary prevention.
• Provide accurate pre-operative cardiac risk assessment for patients undergoing non-cardiac surgeries.
• Accurately read and interpret ECGs, identifying normal and abnormal rhythms.

(B) Medical Knowledge
At the completion of the cardiology rotation, residents will be able to demonstrate medical knowledge of common cardiovascular diseases and “best practice treatment plans” suitable for the family physician, to include being able to:

• Describe normal cardiovascular anatomy and physiology
• List modifiable and non-modifiable risk factors for cardiovascular disease
• Describe the presentation and treatment of stable and unstable angina and acute coronary syndrome/acute MI
• Discuss the pathophysiology, evaluation and treatment of common dysrhythmias, especially atrial fibrillation
• Describe diagnosis, management, and significance of hypertension
• Identify physical findings of common valvular disorders and correlate them with echocardiographic findings
• Describe pathophysiology, diagnosis, and treatment of congestive heart failure

(C) Practice-based Learning and Improvement
At the completion of the cardiology rotation, and subsequently in the family medicine clinic and inpatient setting, when presented with the cardiac patient, residents will be able to:

• Critically evaluate evidence basis for cardiovascular-related diagnosis and treatment such as the use of medications for primary prevention for heart disease.
• Critically evaluate evidence basis for medical and surgical management of acute arterial occlusive disease.
• Interpret and apply treatment guidelines for a variety of cardiovascular-related conditions, such as national cholesterol treatment guidelines and the treatment of hypertension.
• Modify patient treatment plans on an ongoing basis based on patient response to therapy.

(D) Interpersonal and Communication Skills
At the completion of the cardiology rotation, and subsequently in the family medicine clinic and inpatient setting, when presented with the patient with cardiovascular concerns, residents will be able to:

• Obtain a full cardiac history using effective  communication skills with cardiac patients and their families/care takers
• Provide appropriate patient education on cardiovascular diagnosis and treatment as part of a management plan based upon the literacy level of patients and their families/care takers.
• Coordinate care with patient and other team members for chronic disease management of congestive heart failure, cardiac rehabilitation, and other care programs as appropriate.

(E) Professionalism
During the cardiology rotation, residents will exhibit characteristics of a professional health care provider by:

• Dressing appropriately based upon standards present for attending physicians in the clinic and/or inpatient setting associated with the cardiology rotation.
• Demonstrate sensitivity and responsiveness to patients’ perception of illness, and include these perceptions and patient preferences in formulation of management plan.
• Substantively contributing to the learning community in the clinic/hospital associated with the cardiology rotation, by attending and actively participating in educational and research presentations associated with the cardiology rotation.

(F) Systems-based Practice
At the completion of the cardiology rotation, residents will be able to:

• When presented with a patient with cardiovascular disease, describe several ways in which the primary care provider and specialist can work as a healthcare team in providing effective disease management.
• When presented with an acutely or chronically ill cardiac patient, describe the financial implications of health care evaluation and treatment decisions.
• When presented with treating either short-term or chronic disease, will be able to describe formulary implications for medication selection based upon insurance coverage (or lack of coverage) for the patient.