Cardiovascular and Vascular Presentations
Assess stable and complex cardiac and vascular presentations using physiology, ECGs, risk and time-critical differentials.
How to prepare for FRCEM SBA
Protect the full Emergency Medicine curriculum, prioritise the published item counts and practise the decisions expected of a clinician approaching independent practice.
Core concepts
Concept 1
Separate immediately dangerous coronary, rhythm, aortic, thromboembolic and limb-ischaemia syndromes from lower-risk mimics.
Exam cue: Escalate new instability, dynamic ECG change, ongoing ischaemia, pulse deficit, threatened limb or high-risk syncope.
Concept 2
Treat the immediate syndrome, account for bleeding and comorbidity, then define referral, observation, prevention and disposition.
Exam cue: Sequence ECG, biomarkers and targeted imaging according to pre-test probability, clinical trajectory and the decision the result will change.
Risk pitfalls and guardrails
Reassuring yourself with one early normal ECG, biomarker or set of observations despite a high-risk history.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Choosing an answer that is generally true but does not fit the patient's physiology, urgency, evidence or current decision point.
Guardrail: Do not select an option because it is technically true; select the one that best fits the patient's current physiology, evidence, urgency and decision point.
Memory anchors
What frames decisions in cardiovascular and vascular presentations?
Separate immediately dangerous coronary, rhythm, aortic, thromboembolic and limb-ischaemia syndromes from lower-risk mimics.
Which cardiovascular and vascular presentations findings change urgency?
Escalate new instability, dynamic ECG change, ongoing ischaemia, pulse deficit, threatened limb or high-risk syncope.
How should investigation be planned in cardiovascular and vascular presentations?
Sequence ECG, biomarkers and targeted imaging according to pre-test probability, clinical trajectory and the decision the result will change.
What makes management complete in cardiovascular and vascular presentations?
Treat the immediate syndrome, account for bleeding and comorbidity, then define referral, observation, prevention and disposition.
What common error should be avoided in cardiovascular and vascular presentations?
Reassuring yourself with one early normal ECG, biomarker or set of observations despite a high-risk history.
Checkpoint rule
Do the check-up only after you can summarize each concept in one sentence and identify one dangerous pitfall from memory.
Knowledge Check (after reading)
Short check-up to confirm understanding of this module.
Check-up Questions
A 67-year-old man has 40 minutes of crushing central chest pain. The ECG shows 2 mm ST elevation in II, III and aVF with 1 mm ST depression in I and aVL. His blood pressure is 82/54 mmHg, jugular venous pressure is elevated and the lungs are clear. Which immediate management step is most appropriate while primary PCI is activated?
A 74-year-old woman with atrial fibrillation develops sudden severe pain in her left leg. The leg is pale and cool, and femoral and distal pulses are absent. She has reduced sensation in the toes and mild weakness of ankle dorsiflexion. After analgesia, which action should occur next?
Answer all questions to submit.
Next step personalized recommendations
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Move forward only after this module is stable.
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