Advanced Certificate in Small Animal Cardiology

This module reviews important concepts of anatomy and physiology of the cardiovascular system necessary to understand the information discussed during this course. Delegates will get an exhaustive tour of the heart’s external and internal anatomy, the heart’s vasculature, the cardiac conduction system, and the autonomic innervation of the heart and its role in regulating blood pressure. Mechanisms of cardiac electrophysiology,  autonomic regulation of  chronotropy, inotropy, dromotropy, and contractility will also be discussed.

• Identify internal and external landmarks necessary to interpret advanced cardiac imaging
• Describe the normal arrangement of the coronary vessels
• Explain the anatomy and function of the cardiac conduction system
• Summarize the mechanics of cardiac conduction
• List the steps of the cardiac cycle

This module will focus on the diagnosis and treatment of cardiac arrhythmias in a practical fashion where delegates and tutor analyse, interpret and discuss arrhythmia cases together. This is one of the most challenging subjects in cardiology, even for experienced cardiology specialists, which is why it is important that the learning experience mimics real-life clinical work as much as possible. In this first theoretical session a review of all relevant cardiac tachy- and bradyarrhythmias with focus on diagnosis and treatment will be made.

• List all types of arrhythmias highlighting their characteristics and differences
• Distinguish tachy- and bradyarrhythmias base on the ECG characteristics
• Describe the applications of Ambulatory ECG (Holter) for the diagnosis and treatment of arrhythmias
• Describe the steps of an electrophysiology study and radiocatheter ablation of cardiac arrhythmias
• List all treatment options and strategies for the various cardiac arrhythmias

This module will focus on the diagnosis and treatment of cardiac arrhythmias in a practical fashion where delegates and tutor analyse, interpret and discuss arrhythmia cases together. This is one of the most challenging subjects in cardiology, even for experienced cardiology specialists, which is why it is important that the learning experience mimics real-life clinical work as much as possible. In this practical session, a series of cases will be available for analysis by the delegates either individually or in small groups, followed by a detailed analysis and discussion with the tutor.  

• Perform a step-by-step analysis and interpretation of each cardiac arrhythmia
• Diagnose various narrow- and wide-QRS complex tachycardias

Contains a practical session for ECG interpretation

This module will take echocardiography knowledge and skills to the next level. The basics of an echocardiographic examination to the study of the various cardiac conditions encountered during clinical work. The use of echocardiography in a range of acquired conditions will be discussed in a practical fashion and some more advanced echocardiographic techniques will be introduced.

• List all echocardiographic parameters used in the diagnosis of the most common cardiac conditions and describe the information derived from each of these parameters
• Identify and distinguish the echocardiographic parameters used for the diagnosis and staging of chronic valvular degenerative disease.
• Identify and distinguish the echocardiographic parameters used for the diagnosis of dilated cardiomyopathy at the pre-clinical and overt stages.
• Describe the echocardiographic findings in hypertrophic cardiomyopathy in cats
• Explain the Doppler findings in the most common congenital anomalies
• Recognize and describe the pathophysiology of various shunting cardiac defects based on echocardiographic findings

This module will take echocardiography knowledge and skills to the next level. The basics of an echocardiographic examination to the study of the various cardiac conditions encountered during clinical work. The use of echocardiography in a range of acquired conditions will be discussed in a practical fashion and some more advanced echocardiographic techniques will be introduced.

• List all echocardiographic parameters used in the diagnosis of the most common cardiac conditions and describe the information derived from each of these parameters
• Identify and distinguish the echocardiographic parameters used for the diagnosis and staging of chronic valvular degenerative disease.
• Identify and distinguish the echocardiographic parameters used for the diagnosis of dilated cardiomyopathy at the pre-clinical and overt stages.
• Describe the echocardiographic findings in hypertrophic cardiomyopathy in cats
• Explain the Doppler findings in the most common congenital anomalies
• Recognize and describe the pathophysiology of various shunting cardiac defects based on echocardiographic findings

This module will allow the delegate to develop their practical skills under the supervision of an experienced echocardiographer. Tutoring sessions in groups of 3-4 delegates and 1 tutor per ultrasound machine will encourage discussion and learning from everyone’s experience whist ensuring that each delegate spends enough time practicing with the tutor and learning at their own pace.

• Echocardiographic technique, views and machine settings
• Echocardiographic measurements and interpretation

The management of cardiac emergencies is often an intimidating subject. Whilst most veterinary surgeons are comfortable with managing chronic congestive heart failure, the challenge of treating unstable patients, patients with life-threatening cardiac arrhythmias, or even pericardial effusion can be overwhelming. In this module the steps to correctly identify and manage various urgent cardiac conditions will be presented and discussed in detail by an emergency and critical care specialist. This is one of the most important modules of the course.

• Describe the use of point-of-care ultrasonographic techniques for diagnosis of congestive heart failure
• List all treatment options and steps for management of heart failure in dogs and cats
• Explain the steps in the management of arterial thromboembolism in cats and point out the limitations associated with the prognosis of this condition
• Identify various strategies for the treatment of life-threatening cardiac arrhythmias

This module will review the latest information available on the diagnosis and treatment of acquired cardiac disease in dogs. it will be possible to focus on more practical aspects of case management and introduce more advanced information and discussion on the subject (i.e. management of refractory congestive heart failure, review and critical appraisal of the literature on the use of cardiac biomarkers). Given the increase in imported cases of heartworm disease in the UK, an introduction to this disease is also included.

• List the diagnostic criteria and treatment recommendations for the different stages of heart failure
• Cite and critically appraise the existing publications on treatment of chronic valve degenerative disease and dilated cardiomyopathy in dogs
• Describe the diagnostic approach, treatment and prognosis of arrhythmogenic right ventricular cardiomyopathy in dogs
• Distinguish inflammatory myocardial disease from other myocardial disorders
• List available options for treatment of cardiac neoplasia in dogs and their influence on prognosis

The diagnosis and treatment of feline heart disease can be one of the most challenging subjects in veterinary medicine. Practical aspects of case management and challenges will be discussed in detail such as the management of poorly responsive heart failure cases, among other issues. A review and critical appraisal of the literature on the use of cardiac biomarkers in feline cardiac disease will also feature in this module.

• List the diagnostic criteria for distinction of the various feline myocardial diseases
• Describe and explain the treatment options for congestive heart failure in cats
• Cite and critically appraise the existing publications on the use of cardiac biomarkers for the diagnosis of cardiac disease in cats.
• List available options for treatment of cardiac neoplasia in cats and corresponding prognosis

Congenital heart disease is a very challenging topic with so many different congenital abnormalities to learn and understand. In this module, more complex congenital defects will be presented and discussed such as cyanotic congenital heart disease. The diagnosis and treatment of more common congenital defects such as patent ductus arteriosus and pulmonic stenosis, will also be reviewed (i.e. use of Doppler for the diagnosis of congenital heart defects).

• List complex congenital heart defects and their characteristics
• Describe the pathophysiology of cyanotic congenital heart defects
• Explain in detail the diagnostic criteria and clinical management of patent ductus arteriosus
• Explain in detail the diagnostic criteria and clinical management of pulmonic and aortic stenosis

Performing sedation or anaesthesia in patients with heart disease can be scary due to risk of precipitating heart failure or other potentially life-threatening complications. This module is aimed at developing the necessary knowledge and skills to safely anaesthetise a cardiac patient with the guidance of an anaesthesia specialist experienced in the management of these cases. This is an invaluable skill for any veterinary surgeon dealing with dogs or cats with heart disease.

• Describe the potential risks of sedation and anaesthesia in dogs with chronic valve disease, myocardial disease, or various congenital heart defects
• Describe the potential risks of sedation and anaesthesia in cats with a cardiomyopathy or congenital heart disease
• List available sedatives and anaesthetic drugs highlighting their effects in the cardiovascular system
• List available sedation and anaesthesia protocols that are safe to use in the various cardiac conditions found in dogs and cats.
• Explain which monitoring tools should be available during anaesthesia of cardiac patients and how to interpret the information obtained

The heart and the cardiovascular system in general are often targets of damage in a variety of systemic diseases. Chronic systemic illness and endocrine disorders often lead to changes and/or damage of the cardiac tissues that may result in cardiac arrhythmias or even lead to heart failure. Successful management of these consequences is dependent on the correct identification and treatment of the underlying problem as well appropriate use of cardiac medication. In this module, cardiac manifestations of systemic disease and its management will be discussed in detail. 

• Describe the effects of thyroid hormone on cardiac function and list cardiac signs of hyper- and hypothyroidism
• List the cardiovascular effects of various electrolyte imbalances and explain its treatment
• Identify signs suggestive of possible pheochromocytoma and explain how a diagnosis can be obtained
• Describe the effects of cortisol and aldosterone imbalance on the cardiovascular system
• Describe the causes, consequences and treatment of systemic hypertension

Pulmonary hypertension is encountered relatively frequently in our patients and yet remains a challenging and poorly known subject to the majority of veterinary clinicians. In this module, the various causes of pulmonary hypertension will be presented with a detailed discussion on how to identify and treat them appropriately. Given the recent increase of imported cases of heartworm infestation into the UK, this will also be included.

• List the various classes of pulmonary hypertension
• Explain how left heart disease may lead to pulmonary hypertension and describe how to treat it
• Describe the diagnostic steps used in the diagnosis of pulmonary hypertension
• Describe the life cycle of lungworm and heartworm and its implications on diagnosis
• List treatment strategies of heartworm disease

In the past few years we have witnessed significant improvements in the surgical management of various cardiac conditions. In this module the existing surgical and catheter-based techniques used for this purpose will be reviewed, focusing on the indications, results and complications of each technique. This is invaluable information necessary to correctly advise on possible treatment options and avenues for our patients.  

• Describe the options for minimally invasive occlusion of PDA and compare their advantages and limitations with surgical occlusion
• Identify criteria that serve as basis to recommend surgical patch-graft instead of balloon valvuloplasty for the treatment of pulmonic stenosis
• Describe the steps in surgical treatment of mitral valve disease
• List the risks and benefits of mitral valve repair under bypass