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Continuing Medical Education Programs Dr. Anika Niambi Al-Shura, Lecturer Copyright 2014 Niambi Wellness. All rights reserved

Integrative Diagnosing of Cardiovascular Disease Copyright 2014 Niambi Wellness. All rights reserved

Diagnosing in Cardiovascular This course is approved by the following agencies: National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM) for 8 PDA points and Florida State Board of Acupuncture for 10 CEUs. The companion textbook: Diagnosing in Cardiovascular Chinese Medicine must be ordered at www.elsevier.com Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Course Description This course covers the finer details of cardiovascular patient examination techniques and clinical pearls used in western medicine, together with TCM examination techniques. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Course Objectives Understand the 6 basic signs and symptoms connected to cardiac diseases and their clinical significance. Learn the methods and techniques used in physical examination to detect the signs. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Module 4 Fainting Spells Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Contents Chapter 7: Clinical Significance Chapter 8: Examination Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Chapter 7: Clinical Significance Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Contents Part 1: Etiology Part 2: Answers to Textbook Questions Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Part 1: Etiology Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved The main physiological factors involve baroreception and other involvement of the neurological system. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Impulses from baroreception cause vasodilation and constriction. Areas of the neurological system such as the vagus nerve, glossopharyngeal nerve affect the function of the sinus node. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved The two main problems connected to syncope are related to cardiac output cerebral blood flow Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Right ventricular outflow failure contributes to pulmonary hypertension. Left ventricular outflow failure leads to decreased cerebral blood flow. Copyright 2014 Niambi Wellness. All rights reserved

Part 1: Textbook Answers Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Answer block #1 yuan xuan #2 dizziness and vertigo #3 deficiency of blood #4 blood stasis #5 phlegm fire Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Chapter 8:Inquiry and Examination Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Contents Part 1: Inquiry Part 2: Physical Examinations Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Contents Part 3: Cardiac Concerns Part 4: Cerebral Concerns Part 5: Answers to text book questions Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Part 1:Inquiry and Examination Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Inquire about any prior accompanying factors such as: chest pain dyspnea palpitations pain located in the head or back Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved memory problems vision problems speech problems loss of postural tone Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Part 2: Physical Examination Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Main causes include problems with cardiac output and cerebral flow however, there are other unknown causes to consider. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved In some patients, a physical examination and other evaluations may not provide the origins. Copyright 2014 Niambi Wellness. All rights reserved

Part 3: Cardiac Concerns Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Frequent ECG monitoring may be necessary if the patient has been diagnosed with arrhythmias because of their significance. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Prolonged EKG monitoring is suggested for patients: with or without arrhythmia with or without history of syncope Copyright 2014 Niambi Wellness. All rights reserved

Part 4: Cerebral Concerns Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Syncope may be associated with vertebrobasilar disorders associated with ischemia in: vertigo sensory, visual, and motor disorders Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Part 5: Aucsculation Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved There are two common types of tachycardia noticed with palpitations: Paroxysmal atrial fibrillation Sinus tachycardia Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Part 6: Answers to Textbook Questions Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Answer block #6 When did the first episode begin, and since then how often have episodes occurred? #7 problems with sleeping #8 neurological problems #9 dizziness, lightheadedness and fainting when arising from a seated position Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Answer block #10 recent emotional stressors which trigger an episode #11 episodes are isolated or happen so infrequently that patients may not consider them a problem. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Answer block #12 patients may not recount the occurrence and accompanying factors in the narrative. Without witness input, there is little to record in the patient file. #13 can be taken from a sitting, lying or standing position. Observe and assist patient rise to a standing position, as fainting could occur. Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved Answer block #14 Sub-clavian steal syndrome: take the blood pressure from both arms. A change/decrease of 20mmHG may be a positive sign. #15 tachycardia: blood stasis, qi and yin deficiency; bradycardia: blood stasis and phlegm Copyright 2014 Niambi Wellness. All rights reserved

Copyright 2014 Niambi Wellness. All rights reserved

Module 4 Review Questions Copyright 2014 Niambi Wellness. All rights reserved

review interactive practice quiz. Complete the Module 4 review interactive practice quiz. Copyright 2014 Niambi Wellness. All rights reserved

Please continue on to Module 5 Copyright 2014 Niambi Wellness. All rights reserved