CVS MODULE

3 weeks
 Introduction
The KMU-IMS Cardiovascular-II (CVS-II) Module is designed to provide basic and clinical
knowledge along with practical skills to the 3rd year MBBS students. The module is aligned
to the general outcomes required at the exit level, and includes sessions on pathological
mechanisms, preventive medicine, pharmacological aspects, communication skills,
professionalism, self-management, medicolegal aspects, clinical application of knowledge
and skills. The purpose is to facilitate the student learning.

Faculty Designation Email address

Dr Asifullah Module Director/Head of [Link]@[Link]

Cardiology Department

KMU-IMS Kohat

Dr Tahira Atta Associate Prof. Pathology [Link]@[Link]

KMU-IMS Kohat

Dr Zakia Subhan Assistant Professor KMU- zakiabilal10@[Link]

IMS Kohat

Reviewed and finalized by:

Dr. Farooq Ahmed, Director of Medical Education, KMC, Peshawar

Themes for CVS-II Module

S. No. Theme Title Week No.

Theme 1 Chest Pain 2 (1)

Theme 2 blood pressure 1

Theme 3 Shortness of breath 2 (1)

Subject TOPIC Hours S. Learning objectives
needed No
At the end of this module,
students of year 3 will be able to:

Theme 1: Chest pain

Anatomy Gross anatomy of 1 1 Describe surface anatomy of the
heart, valves and heart and heart valves
coronary arteries

2 Describe the anatomy of coronary

circulation

3 Enumerate heart valves and

describe their gross morphology

Biochemistry Lipoproteins and 1 4 Classify and Describe types of

cholesterol lipoproteins

5 Summarize cholesterol synthesis

Pathology Atherosclerosis 1 6 Discuss the risk factors,

Morphology, pathological changes
and consequences of
Atherosclerotic plaque

Ischemia and 7 Define Ischemia and infarction,

infarction and differentiate it from
infarction
8 Discuss Classification and
pathophysiology of ischemic heart
disease
9 Discuss pathophysiology of
myocardial infarction
Pharmacology Antianginal drugs 1 10 Classify antianginal drugs

11 Explain mechanism of action,

pharmacokinetics and adverse
effects of organic nitrates and
calcium channel blockers

12 Explain the rationale for use of 𝛃-

adrenergic blockers and sodium
channel blocker in the
management of angina pectoris
Lipid lowering drugs 2 13 Briefly describe the types of
dyslipidemias
 14 List the lipid lowering drug classes

15 Explain the mechanism of action,

effect on serum lipid profile and
adverse effects of each of the five
drug classes

16 Discuss drug-drug interaction of

lipid lowering drugs
Anticoagulant drugs 2 17 Classify anticoagulant drugs

18 Discuss mechanism of action, uses

of Unfractionated heparin

19 Compare low molecular weight

and unfractionated heparin

20 Describe adverse effects of

heparin and treatment of heparin
overdose
21 Describe mechanism of action and
uses of direct Xa and IIa inhibitors
22 Describe mechanism of action and
uses of warfarin

23 Describe adverse effects of

warfarin and treatment of
warfarin overdose
24 Compare heparin and warfarin in
terms of mechanism and onset of
action

25 Explain monitoring of
anticoagulant therapy
26 Describe important diet and drug
interactions of warfarin
Antiplatelet and 1 27 Classify antiplatelet drugs
thrombolytic drugs

28 List indications of antiplatelet

therapy

29 Explain the mechanism of action

and adverse effects of each
antiplatelet drug group
30 Name thrombolytic drugs and
explain their mechanism of
action, uses and adverse effects
Forensic Medicine Chest trauma 1 31 Describe heart injuries caused by
regional injuries
 32 Discuss chest wall injuries in
general
33 Enumerate the complications of
rib fracture
Sudden death 1 34 Define sudden death

35 Explain the causes of sudden death

36 Describe autopsy findings in

sudden death
37 Describe the medicolegal
importance of sudden death
Community Non-communicable 2 38 Define Cardiovascular disease
Medicine diseases: (CVD)

Cardiovascular
diseases as public
health issues

39 Elaborate the concept of CVD risk

stratification

40 Describe the epidemiology of

cardiovascular diseases and
explain cardiovascular diseases of
Public Health importance globally
and in Pakistan
41 Explain the known risk factors of
CVD and cultural, racial and
gender difference in CVD
prevalence and incidence
Hypertension Describe the epidemiology of
hypertension and its public Health
importance globally and in
Pakistan
General Coronary Heart 1 42 Discuss CAD risk factors and
Medicine/Cardiology disease strategies to reduce them

43 Discuss strategies for primary and

secondary prevention of CHD in
outpatient setting

44 Define chronic stable angina, its

clinical signs and symptoms,
laboratory findings, imaging
techniques for assessment of it
and management protocols
 45 Discuss coronary vasospasm and
angina with normal coronary
angiograms
Acute coronary 1 46 Define Acute coronary syndrome
syndrome

47 Explain the spectrum of illness in

ACS and relevant management
steps
48 Describe the clinical features and
steps of the management of
Myocardial infarction

49 Describe risk stratification in

myocardial infarction

50 Describe complications of acute

MI
Hypertrophic 51 Discuss clinical features, imaging
cardiomyopathy protocols, risk stratification and
short/long-term management of
hypertrophic cardiomyopathy
PRIME/MEDICAL Informed consent 1 Obtaining informed consent from
EDUCATION a patient before an invasive
procedure
Theme 2: Blood Pressure
Pathology Blood pressure 2 52 Describe the mechanisms of blood
pressure regulation
Shock 53 Classify shock

54 Describe the pathophysiology and

types of shock
55 Describe the stages pf shock

56 Define sepsis and septic shock

57 Discuss causes, pathogenesis, and

laboratory findings in shock
58 Discuss Disseminated
intravascular coagulation in the
context of sepsis
59 Describe classification and
pathophysiology of Hemorrhage
Hypertension 1 60 Describe the causes, Pathogenesis,
morphology and complications of
Hypertension
 Aneurisms 1 61 Discuss pathophysiology of
hypertension in pregnancy
62 Describe the etiology, morphology
and manifestations of vascular
aneurisms
63 Describe the causes, Pathogenesis
and types of Aortic Aneurysm
Aortic dissection 64 Describe the pathogenesis,
morphology and clinical features
of Aortic Dissection
Vasculitis 1 65 Define vasculitis

66 Classify vascilitides

67 Describe the immunological

mechanisms of non-infectious
vasculitis
68 Describe the morphology and
clinical features of Giant cell
arteritis
69 Describe the morphology and
clinical features of Takayasu
arteritis
70 Describe the morphology and
clinical features of Polyarteritis
nodosa
71 Describe the morphology and
clinical features of Kawasaki
disease
72 Describe the morphology,
serological markers and clinical
features of Wegener
granulomatosis
73 Describe the morphology and
clinical features of Thromboangitis
obliterans
Diseases of veins 1 74 Differentiate between
thrombophlebitis and
Phlebothrombosis
75 Describe the etiology and clinical
features of varicose veins
76 Enlist the benign and malignant
tumors of the arteries and veins
Pharmacology Antihypertensive 2 77 Classify antihypertensive drugs
drugs

78 Discuss role of diuretics in the

management of hypertension
 79 Discuss the role of ACE inhibitors,
Angiotensin receptor-blocking
agents, Renin inhibitor in
hypertension
80 Explain the rationale for the use of
β-blockers, α-adrenoceptor
blocking agent, centrally acting
sympatholytic drugs in
hypertension
81 Describe the direct vasodilators
(mechanism of action and drug
toxicity) in relation to
antihypertensive drug therapy
82 Describe the role of Calcium
channel blockers in hypertension
General Hypertension 1 83 Define and classify hypertension
Medicine/Cardiology

84 Discuss drug treatment protocols

for hypertension
85 Describe the risk factors and
complications of hypertension
86 Describe the management of
hypertensive emergencies and
urgencies
Forensic medicine Cardiac poisons 1 87 Classify Cardiac Poisons

88 Describe the characteristic, clinical

signs/symptoms, treatment and
medicolegal aspects of cardiac
glycosides
89 Discuss cardiac effects of
methylphenidate, cocaine and Ice
90 Describe the characteristic, clinical
signs/symptoms, treatment and
medico legal aspects of Oleander
PRIME/MEDICAL Counselling skills 1 Develops counselling skills in
EDUCATION professional life

Theme 3: Shortness of breath

Physiology Cardiac cycle 1 91 Outline major events in cardiac
cycle
92 Discuss physiology of heart sounds
and murmurs
Pathology Congestive heart 2 93 Describe the types, etiology,
failure pathogenesis, and clinical features
of congestive heart failure
 Cardiomyopathies 94 Describe the Pathological
patterns, causes, morphological
changes and clinical features of
Cardiomyopathies
Congenital heart 2 95 Describe the Etiology,
diseases Pathogenesis and clinical features
of Tetrology of Fallots, ASD, VSD
and pulmonary stenosis
Valvular heart 96 Describe the Etiology,
diseases pathogenesis and clinical features
of Aortic stenosis, Aortic
regurgitation, Mitral stenosis and
Mitral regurgitation
Rheumatic fever 1 97 Discuss pathophysiology and
laboratory findings in rheumatic
fever
Rheumatic heart 98 Discuss pathological changes and
disease morphology of rheumatic heart
disease
Thrombosis and 1 99 Describe the mechanism and
Embolism pathogenetic mechanisms of
vascular thrombosis
100 Enlist hypercoagulable states

101 Define embolism

102 Discuss types of embolism

103 Describe the etiology,

pathogenesis, morphology and
clinical features of pulmonary
embolism
Endocarditis 1 104 Discuss Etiology, Pathogenesis,
Morphology, diagnostic criteria,
clinical features and complications
of infective endocarditis
105 Discuss the types of non-infected
vegetation
Pharmacology Drugs used in heart 2 106 Define the different classes of the
failure drug used in the treatment of
heart failure
107 Explain the pharmacological
effects, clinical uses, adverse
effects and drug interactions of
digitalis glycosides

108 Explain the signs symptoms and

treatment of digoxin overdose
 109 Enlist positive inotropic drugs
(other than digoxin) that are used
in heart failure

110 Classify the five major groups of

diuretic drugs and relate them to
their site of action
111 Discuss the mechanism of action,
clinical applications and adverse
effects of carbonic anhydrase
enzyme inhibitors, osmotic
diuretics, thiazide diuretics, loop
diuretics and potassium sparing
diuretics
112 Enlist potassium sparing and
potassium losing diuretics
Antiarrhythmic 2 113 Classify antiarrhythmic drugs
drugs

114 Describe the effect of different

classes of antiarrhythmic drugs on
membrane potential of
cardiomyocytes
115 Explain the mechanism of action
of all the classes of antiarrhythmic
drugs
116 Discuss the adverse effects and
clinical uses of antiarrhythmic
drugs
General Heart failure 1 117 Discuss workup and management
Medicine/Cardiology of pulmonary edema

118 Enlist and explain causes of heart

failure
119 Describe workup and
management of heart failure
Disorders of heart 1 120 Classify arrhythmias and heart
rate and rhythm blocks

121 Describe the etiology, ECG findings

and management of Atrial
fibrillation
122 Discuss types, workup and
management of ventricular
arrhythmias
Pulmonary 1 123 Describe the etiology, clinical
embolism features and diagnostic workup of
pulmonary embolism
124 Discuss risk stratification and
management of pulmonary
embolism
 Pulmonary 125 Discuss cardiac causes of
hypertension pulmonary hypertension and
outline their management
Myocarditis 1 126 Discuss causes and management
of myocarditis
Pericardial diseases 127 Define and classify pericarditis

128 Discuss clinical findings and

treatment of pericarditis
129 Describe the etiology and
management of pericardial
effusion
Pediatrics Cyanotic and 1 130 Delineate the difference between
acyanotic congenital the acyanotic and cyanotic heart
heart disease disease conditions

131 Enumerate the various defects,

involving both conditions
Rheumatic fever 1 132 Describe the etiology of rheumatic
fever
133 Describe Duckett Johns criteria for
diagnosis of RF
134 Discuss about primary and
secondary prophylaxis of
rheumatic heart disease
PRIME/MEDICAL SWOT Analysis 1 Perform SWOT analysis for a
EDUCATION particular task

Practical work

Pharmacology Myocardial 1.5 135 Construct a prescription for a

Infarction patient with Myocardial Infarction

Hypertension 1.5 136 Construct a prescription for a

patient with Hypertension
Congestive Cardiac 1.5 137 Construct a prescription for a
Failure patient with Congestive Cardiac
Failure
Pathology Lipid Profile 1.5 138 Demonstrate Estimation of total
cholesterol

Hemangioma 1.5 139 Identify the morphological

changes occurring in hemangioma
Forensic medicine Cardiac toxins 1.5 140 Identify the following cardiogenic
toxins:
• Digitalis
• Cannabis
• Heroin

Hours allocation to different subjects

S. No Subject Hours needed
1 Pathology 18

2 Pharmacology 20

3 Forensic medicine 2

4 Community medicine 2

5 General medicine / cardiology 7

6 Pediatrics 2

7 Anatomy 1

8 Physiology 1

9 Biochemistry 1

10 PRIME/MEDICAL EDUCATION 3

Total 57