Lesson 1Directed chest pain history: characteristics, radiation, duration, exertional vs rest, associated symptoms (diaphoresis, nausea, syncope)This section teaches a focused, structured chest pain history, including location, quality, radiation, duration, triggers, and associated symptoms, to distinguish ischemic, pulmonary, musculoskeletal, and gastrointestinal causes and guide next steps in resource-limited settings.
Location, quality, and radiation of chest painOnset, duration, and temporal pain patternsExertional, positional, and pleuritic featuresAssociated symptoms: diaphoresis, nausea, syncopeDifferentiating cardiac from noncardiac painLesson 2Genitourinary and endocrine screening: polyuria, polydipsia, nocturia, ED, weight changes, family history of diabetesThis section outlines targeted genitourinary and endocrine screening relevant to cardiometabolic disease, including polyuria, polydipsia, nocturia, ED, weight change, and diabetes family history, to uncover undiagnosed or poorly controlled disease in local communities.
Polyuria, polydipsia, and hyperglycemia cluesNocturia patterns and volume status assessmentErectile dysfunction and vascular riskUnintentional weight loss or gain patternsFamily history of diabetes and endocrine diseaseLesson 3Medication, allergy, and supplement review: OTCs, herbal remedies, NSAID use and potential BP effectsThis section explains how to obtain a precise medication, allergy, and supplement history, including OTCs, herbal products, and NSAID use, with emphasis on interactions, blood pressure effects, adherence, and documentation for safe prescribing in Sierra Leone.
Systematic prescription medication reconciliationIdentifying and classifying drug allergiesOTC and herbal supplement interaction risksNSAID use, fluid retention, and BP elevationAssessing adherence and barriers to regimensLesson 4Symptom red flags and timeline: sudden worsening, syncope, hemoptysis, lower-extremity swelling, feverThis section covers identification of symptom red flags and temporal patterns, including sudden worsening, syncope, hemoptysis, edema, and fever, and teaches how to construct timelines that guide triage, differential diagnosis, and escalation in primary care.
Eliciting sudden versus gradual symptom onsetRecognizing syncope and presyncope red flagsHemoptysis, fever, and infection concernsLower-extremity swelling and volume overloadConstructing a clear symptom chronologyLesson 5Functional and cognitive screening: activities of daily living, depression/anxiety screening, cognition relevant to shared decision-making and adherenceThis section addresses functional and cognitive screening in cardiometabolic care, including ADLs, IADLs, mood, cognition, and health literacy, to identify limitations that affect prognosis, shared decisions, and treatment adherence among Sierra Leonean patients.
Assessing ADLs and instrumental ADLsScreening for depression and anxiety symptomsBrief cognitive screening tools in practiceEvaluating health literacy and understandingLinking function and cognition to adherenceLesson 6Social determinants and behavioral risk factors: tobacco use history (pack-years), alcohol use screening (AUDIT-C principles), diet, sleep, occupational activityThis section details how to assess social determinants and behaviors that shape cardiometabolic and cardiopulmonary risk, including tobacco, alcohol, diet, sleep, and occupational activity, and how to document and counsel patients effectively in local contexts.
Assessing tobacco history and pack-year calculationScreening alcohol use with AUDIT-C principlesEvaluating diet quality and cardiometabolic impactSleep duration, quality, and cardiopulmonary effectsOccupational activity, sedentary time, and workloadLesson 7Cardiovascular risk and past medical history: prior hypertension, hyperlipidemia, known CAD, stroke, PAD, medications and adherenceThis section reviews how to obtain targeted cardiovascular risk and past medical history, including hypertension, lipids, CAD, stroke, PAD, diabetes, and medication adherence, to estimate risk and tailor prevention and treatment plans for Sierra Leonean adults.
Documenting hypertension and BP control historyHyperlipidemia, statin use, and lipid goalsPrior CAD, MI, revascularization, and anginaHistory of stroke, TIA, and peripheral artery diseaseDiabetes, CKD, and other risk-enhancing factorsLesson 8Dyspnea and exertional intolerance: onset, orthopnea, PND, DOE, activity level quantification, prior baseline functionThis section focuses on structured assessment of dyspnea and exertional intolerance, including onset, triggers, orthopnea, PND, DOE, and baseline function, to differentiate cardiac, pulmonary, and other causes and guide urgency of evaluation in clinics.
Characterizing onset, pattern, and progressionOrthopnea and paroxysmal nocturnal dyspneaQuantifying DOE and activity limitationsComparing current status to prior baselineDistinguishing cardiac from pulmonary dyspnea
