Lesson 1Directed chest pain history: characteristics, radiation, duration, exertional vs rest, associated symptoms (sweating, nausea, fainting)This section teaches a focused, structured chest pain history, including location, quality, radiation, duration, triggers, and associated symptoms, to distinguish ischaemic, 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: sweating, nausea, faintingDifferentiating cardiac from noncardiac painLesson 2Genitourinary and endocrine screening: frequent urination, excessive thirst, night urination, erectile dysfunction, weight changes, family history of diabetesThis section outlines targeted genitourinary and endocrine screening relevant to cardiometabolic disease, including frequent urination, excessive thirst, night urination, erectile dysfunction, weight change, and diabetes family history, to uncover undiagnosed or poorly controlled disease in local communities.
Frequent urination, excessive thirst, and high blood sugar cluesNight urination patterns and fluid status assessmentErectile dysfunction and vascular riskUnintentional weight loss or gain patternsFamily history of diabetes and endocrine diseaseLesson 3Medication, allergy, and supplement review: over-the-counter medicines, herbal remedies, NSAID use and potential blood pressure effectsThis section explains how to obtain a precise medication, allergy, and supplement history, including over-the-counter medicines, herbal products, and NSAID use, with emphasis on interactions, blood pressure effects, adherence, and documentation for safe prescribing in Zimbabwe.
Systematic prescription medication reconciliationIdentifying and classifying drug allergiesOver-the-counter and herbal supplement interaction risksNSAID use, fluid retention, and blood pressure elevationAssessing adherence and barriers to regimensLesson 4Symptom red flags and timeline: sudden worsening, fainting, coughing blood, lower-leg swelling, feverThis section covers identification of symptom red flags and temporal patterns, including sudden worsening, fainting, coughing blood, swelling, and fever, and teaches how to construct timelines that guide triage, differential diagnosis, and escalation in primary care.
Eliciting sudden versus gradual symptom onsetRecognising fainting and pre-fainting red flagsCoughing blood, fever, and infection concernsLower-leg swelling and fluid overloadConstructing a clear symptom chronologyLesson 5Functional and cognitive screening: daily activities, depression/anxiety screening, cognition relevant to shared decision-making and adherenceThis section addresses functional and cognitive screening in cardiometabolic care, including daily activities, instrumental activities, mood, cognition, and health literacy, to identify limitations that affect prognosis, shared decisions, and treatment adherence in diverse populations.
Assessing daily activities and instrumental activitiesScreening for depression and anxiety symptomsBrief cognitive screening tools in practiceEvaluating health literacy and understandingLinking function and cognition to adherenceLesson 6Social determinants and behavioural 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 behaviours that shape cardiometabolic and cardiopulmonary risk, including tobacco, alcohol, diet, sleep, and occupational activity, and how to document and counsel patients effectively in Zimbabwean 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 high blood pressure, high cholesterol, known coronary artery disease, stroke, peripheral artery disease, medications and adherenceThis section reviews how to obtain targeted cardiovascular risk and past medical history, including high blood pressure, lipids, coronary artery disease, stroke, peripheral artery disease, diabetes, and medication adherence, to estimate risk and tailor prevention and treatment plans.
Documenting high blood pressure and blood pressure control historyHigh cholesterol, statin use, and lipid goalsPrior coronary artery disease, heart attack, revascularisation, and anginaHistory of stroke, transient ischaemic attack, and peripheral artery diseaseDiabetes, chronic kidney disease, and other risk-enhancing factorsLesson 8Shortness of breath and exertional intolerance: onset, orthopnea, paroxysmal nocturnal dyspnoea, dyspnoea on exertion, activity level quantification, prior baseline functionThis section focuses on structured assessment of shortness of breath and exertional intolerance, including onset, triggers, orthopnea, paroxysmal nocturnal dyspnoea, dyspnoea on exertion, and baseline function, to differentiate cardiac, pulmonary, and other causes and guide urgency of evaluation.
Characterising onset, pattern, and progressionOrthopnea and paroxysmal nocturnal dyspnoeaQuantifying dyspnoea on exertion and activity limitationsComparing current status to prior baselineDistinguishing cardiac from pulmonary shortness of breath
