Lesson 1Social and behavioural history: smoking, alcohol, occupation, living conditions, exercise, salt intakeExplores methods to collect targeted social and behavioural details, covering smoking habits, alcohol consumption, job-related factors, environmental risks, home setup, eating patterns, physical activity, and salt levels, and their effects on heart and lung health risks.
Smoking history, pack-years, and quitting stageAlcohol consumption, screening, and adviceOccupation, 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, haemoptysis, sudden worsening, severe hypotensionCovers identifying and investigating critical symptoms like fainting, sudden chest pain, coughing up blood, abrupt breathlessness, and low blood pressure, stressing timing, linked features, and urgent escalation for emergency treatment.
Characterising acute chest pain and onsetAssessing syncope, presyncope, and collapseEvaluating haemoptysis volume and triggersSudden dyspnoea and suspected pulmonary embolismRecognising 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 responsesEmphasises developing rapport, employing open and specific queries, addressing patient worries, summarising discussions, providing safety advice, and meticulously noting symptoms, times, and replies in a comprehensive, legally sound clinical record.
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, ischaemic heart disease, valvular disease, rheumatic fever, COPD, sleep apnoea, anaemia, renal diseaseAddresses focused enquiries into heart and lung related conditions, such as high blood pressure, coronary artery disease, valve problems, rheumatic fever, chronic obstructive pulmonary disease, sleep apnoea, low blood count, and kidney issues, and their influence on risk and possible diagnoses.
Clarifying prior cardiac diagnoses and interventionsDocumenting hypertension duration and controlHistory of rheumatic fever and valvular sequelaeChronic lung disease, COPD, and asthma detailsSleep apnoea, obesity hypoventilation, and CPAP useRenal disease, anaemia, and cardiorenal interactionsLesson 5System-specific symptom screens: cough, wheeze, chest pain, palpitations, oedema distribution, urinary symptomsDirects targeted checks for breathing, heart, and kidney symptoms, encompassing cough, wheezing, chest discomfort, irregular heartbeat, swelling patterns, urine alterations, and overall signs that help narrow down potential causes.
Respiratory review: cough, sputum, and wheezeCardiac review: chest pain and palpitationsPeripheral oedema pattern and distributionNocturia, oliguria, and renal congestion signsSystemic symptoms: fever, weight loss, fatigueLinking system findings to differential diagnosisLesson 6Targeted symptom history: dyspnoea onset, progression, orthopnoea, paroxysmal nocturnal dyspnoea, exertional toleranceInstructs on systematic probing of breathlessness, including its start, worsening, lying-flat discomfort, night-time waking with breathlessness, effort capacity, cough, and related issues, highlighting triggers, development, and effects on routine life.
Onset and progression of dyspnoea timelineOrthopnoea and paroxysmal nocturnal dyspnoeaExertional tolerance and activity limitationCough, sputum, and wheeze characterisationChest tightness, pain, and palpitationsImpact on sleep, work, and daily functioningLesson 7Family history and risk factors: premature cardiovascular disease, cardiomyopathies, thrombophiliaDiscusses gathering family background on early heart conditions, muscle diseases of the heart, rhythm disorders, clotting tendencies, and unexpected deaths, while incorporating inherited and common lifestyle risks into overall risk evaluation.
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 changesExamines thorough review of drug history, encompassing prescribed items, over-the-counter remedies, natural supplements, latest modifications, compliance obstacles, unwanted effects, and clashes pertinent to heart-lung conditions and flare-ups.
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
