CVS (Block 3): Lub Dub

The Cardiovascular (CVS) block. Here you'll learn that the heart wants what the heart wants - and failure is not one of those things. This is a pretty cool block in terms of doctory things. You'll learn how to read an ECG (or EKG for our friends from the States). So next time you watch Grey's and McDreamy or McFlurry, or whoever, looks at an ECG, you can be like "Pfft, that's not how it's done!" To be honest, you'll still not really know how to identify pathology on an ECG strip, but you will know what the deflections mean, which is a start.

CVS consists of six weeks. Here the topics flow from one week to the next, which is quite neat. Week one is meant to teach the basics of cardiac function - physiology, anatomy (cadavers, yay.), pharmacology (same stuff from PCMS, again), etc. The physiology is really important. It forms the basis of the rest of the block. Week one delves into syncope a little. That means "passing out". If you get asked - the commonest cause of syncope is vasovagal. People love this question for some reason. (Google it)

Week two... ahh heart failure! Probably my favourite topic in GEMP I. I enjoyed it because it really is logical. Once you understand the normal cardiac cycle, heart failure becomes a breeze. Not for the patient, of course. I remember tutoring this topic quite a few times, so if you need any help, just send me a message via the Facebook page. You will learn some interesting new terms such as orthopnoea and paroxysmal nocturnal dyspnoea (PND) - described as awakening very short of breath at night. For those who are interested: PND is NOT because the patient lies flat; this is archaic. It's as a result of the diurnal variation of antidiuretic hormone (ADH) which increases at night. In the exams though (and this is important), just say whatever the notes say.

Hypertension is the topic for week three. A huge burden worldwide. The course pack is really very good for this week, so make sure you understand it very well. What's important is to understand what contributes to the systolic and the diastolic components of blood pressure.

Ahhhh good ol' myocardial infarctions (MI)! Week four will teach you all about heart attacks. The classic crushing chest pain and pain in the arm. Interestingly, the pain in the arm is as a result of referred pain. As the inflammation reaches the pericardium is involves the phrenic nerve (which originates in the cervical cord roots 3, 4 and 5). C3, 4 and 5 also gives sensation to the area of the arm which hurts during an MI. I doubt that anyone will teach this to you, I just kinda logically thought it out.

Week five goes into Rheumatic Fever (RF) and Rheumatic heart disease. As Dr King says: "RF licks the joints and bites the heart." In this week the structure of the heart valves are important. RF is caused by Group A Beta Haemolytic Streptococci. This friendly bug is found in many a pharynx, but doesn't cause RF is everyone. An underlying autoimmune mechanism plays a role (M proteins and such). Oh, and this week also dabbles in pregnancy and the heart. I'll chat more about that when I post about Obstetrics (ohh the horror!!).

The final week. By now you should be stressing, not too much, but not too little. Juuust right. Exams are around the corner. Don't worry though, if you've been working consistently throughout the block you'll be fine! Week six will cover the Paediatric aspect of the CVS. You will learn more about the Tetralogy of Fallot (silent 't') and some embryological considerations. Don't miss those lectures! This week is unbelievably important for your GEMP III Paeds block. I seriously wish someone had told me that...

And that's CVS in a heart beat. Good luck!