Lesson 1Social and behavioural history: smoking, alcohol, occupation, living conditions, exercise, salt intakeAddresses how to obtain a focused social and behavioural history, including smoking, alcohol, occupation, environmental exposures, living conditions, diet, exercise, and salt intake, and how these influence cardiopulmonary risk in diverse Canadian populations.
Smoking history, pack-years, and cessation stageAlcohol intake, screening, and counsellingOccupation, dust, and chemical exposuresHome environment, heating, and dampnessPhysical activity, exercise, and limitationsDietary patterns, salt intake, and weightLesson 2Red flag and alarm symptoms: syncope, chest pain, hemoptysis, sudden worsening, severe hypotensionDetails recognition and exploration of red flag symptoms such as syncope, acute chest pain, hemoptysis, sudden dyspnea, and hypotension, emphasizing time course, associated features, and when to escalate for emergency care in line with Canadian guidelines.
Characterizing acute chest pain and onsetAssessing syncope, presyncope, and collapseEvaluating hemoptysis volume and triggersSudden dyspnea and suspected pulmonary embolismRecognizing shock, hypotension, and poor perfusionEscalation thresholds and emergency referralLesson 3Communication skills and documentation: open questions, focused clarifying questions, safety netting and recording key timestamps and responsesFocuses on building rapport, using open and focused questions, exploring patient concerns, summarizing, safety netting, and accurately documenting symptoms, timestamps, and responses in a clear, medico-legal clinical record compliant with Canadian standards.
Structuring the cardiopulmonary interviewUsing open questions to elicit the narrativeFocused clarifying questions for key symptomsChecking understanding and shared agenda settingSafety netting, red flag advice, and follow-upAccurate, time-stamped clinical documentationLesson 4Past medical history probes: hypertension, ischemic heart disease, valvular disease, rheumatic fever, COPD, sleep apnea, anemia, renal diseaseCovers targeted questioning about cardiovascular and respiratory comorbidities, including hypertension, ischemic and valvular disease, rheumatic fever, COPD, sleep apnea, anemia, and renal disease, and how these shape risk and differential diagnosis in Canadian practice.
Clarifying prior cardiac diagnoses and interventionsDocumenting hypertension duration and controlHistory of rheumatic fever and valvular sequelaeChronic lung disease, COPD, and asthma detailsSleep apnea, obesity hypoventilation, and CPAP useRenal disease, anemia, and cardiorenal interactionsLesson 5System-specific symptom screens: cough, wheeze, chest pain, palpitations, edema distribution, urinary symptomsGuides system-based screening for respiratory, cardiac, and renal symptoms, including cough, wheeze, chest pain, palpitations, edema pattern, urinary changes, and constitutional features that refine the differential diagnosis in primary care settings.
Respiratory review: cough, sputum, and wheezeCardiac review: chest pain and palpitationsPeripheral edema pattern and distributionNocturia, oliguria, and renal congestion signsSystemic symptoms: fever, weight loss, fatigueLinking system findings to differential diagnosisLesson 6Targeted symptom history: dyspnea onset, progression, orthopnea, paroxysmal nocturnal dyspnea, exertional toleranceTeaches structured exploration of dyspnea, orthopnea, paroxysmal nocturnal dyspnea, exertional tolerance, cough, and associated symptoms, focusing on onset, progression, triggers, and functional impact on daily activities for Canadian patients.
Onset and progression of dyspnea timelineOrthopnea and paroxysmal nocturnal dyspneaExertional tolerance and activity limitationCough, sputum, and wheeze characterizationChest tightness, pain, and palpitationsImpact on sleep, work, and daily functioningLesson 7Family history and risk factors: premature cardiovascular disease, cardiomyopathies, thrombophiliaCovers eliciting family history of premature cardiovascular disease, cardiomyopathies, arrhythmias, thrombophilia, and sudden death, and integrating genetic and shared lifestyle risks into risk stratification for diverse Canadian families.
Premature coronary artery disease in relativesInherited cardiomyopathies and channelopathiesFamily history of venous thromboembolismSudden unexplained death and arrhythmiasShared lifestyle and environmental factorsWhen to consider genetic counselling referralLesson 8Medication review and adherence: prescription, OTC, herbal, adherence barriers, recent changesExplores systematic medication history taking, including prescriptions, OTC and herbal drugs, recent changes, adherence barriers, side effects, and interactions relevant to cardiopulmonary disease and decompensation in Canadian healthcare.
Listing all prescription and OTC medicationsIdentifying cardioactive and respiratory drugsRecent medication changes and decompensationAssessing adherence, beliefs, and routinesDetecting adverse effects and drug interactionsInhaler technique and device-related issues
