Cardiac Imaging

​General objectives

 This rotation is primarily intended for senior residents.  Residents are expected to have a general knowledge of all forms of cardiac imaging and all of their roles in investigation of acquired and congenital heart disease.  After completion of this rotation, the resident will have a basic knowledge of interpretation of cardiac imaging, and will be able to function at a general radiologist level in interpretation of common diseases.  The resident will be able to supervise and report basic cardiac CT and vascular MRI and CT examinations to the required level of competence for general radiology practice.  This exposure will not necessarily fulfill but can be used toward provincial licensing requirements.

Specific Objectives

 At the completion of the cardiac rotation, resident will have acquired following competencies.
Medical expert
Specific Requirements:
  Demonstrate knowledge of normal cardiac and coronary anatomy, and coronary artery territories, in conventional and multiplanar imaging planes
  Demonstrate knowledge of normal cardiac physiology and cycle
  Demonstrate knowledge of atherosclerosis and ischemia pathophysiology, myocardial perfusion as it pertains to radiologic imaging
  Apply the appropriate imaging modalities for investigation of cardiovascular disease and be able to list the risks and benefits of each
  Demonstrate knowledge of atherosclerotic/ ischemic disease, valve disease, cardiomyopathy, pericardial disease, aortic/vascular disease, common congenital heart diseases, common post-operative conditions and know the appropriate imaging modalities for each of these
  Explain the importance of informed consent , potential complications for each modality and demonstrate knowledge and ability to manage complications effectively
  Describe invasive procedures such as angioplasty and myocardial biopsy, with the benefits and disadvantages of these procedures
  Basic knowledge of relevant laboratory tests such as ECG, stress tests, cardiac enzymes as they apply to cardiac disease
  Apply fundamentals of quality assurance with regard to cardiac CT
  Demonstrate knowledge of pertinent differential diagnoses as they relate to atherosclerotic/ ischemic disease, valve disease, cardiomyopathy, pericardial disease, aortic/vascular disease, common congenital heart diseases, common post-operative conditions
  Supervise and interpret basic aortic and vascular MRI, coronary CT, vascular CT
  Demonstrate knowledge of basic echocardiographic views, recognition of common disease on echocardiography and advantages and disadvantages of echocardiography
  Explain basic physics and technical factors of CT and MR as they apply to cardiac imaging
  List theoretical, practical, and legal aspects of radiation protection and possible harmful effects of CT and angiography pertinent to cardiac imaging
Specific Requirements:
§  Apply a sound and systematic style for reporting CT, MRI, nuclear medicine and echocardiography related to cardiac disease
§  Assemble a report that succinctly describes cardiac imaging findings, mostly likely differential diagnoses, and recommends appropriate further testing or management when indicated.
§  Dictate and verify reports in a timely fashion
§  Understand the importance of and demonstrate the ability to communicate with referring clinicians, particularly when the results of an investigation or radiological procedure should be urgently communicated
Specific Requirements:
§  Consult effectively with other physicians and health care professionals
§  Function as a member of a multidisciplinary health care team in a radiology department
§  Able to supervise and work together with both nursing and technical staff
§  Able to suggest alternative imaging modalities when appropriate for a specific clinical situation
Specific Requirements:
§  Understand quality assurance issues related to cardiac imaging, including but not limited to incorrect interpretation of studies, and technical parameter optimization
§  Able to manage the daily workflow at a senior resident level
§  Interpret and perform appropriate volume of cases for level of training to ensure adequate exposure to the wide spectrum of pathology relating to cardiac imaging
Health Advocate
Specific Requirements:
§  Understand the benefits and risks of CT and MR investigations including economic considerations and issues with access
§  Educate and advise on the use and misuse of cardiac imaging
Specific Requirements:
§  Be competent in the evaluation of the medical literature pertaining to cardiac imaging
§  Demonstrate the ability to be an effective teacher to medical students, fellow residents, technologists, nurses, and clinical colleagues
Specific Requirements:
§  Punctuality, attendance, reliability and respect in the workplace
§  Be able to accurately assess one’s own performance, strengths and weaknesses
§  Be aware of one’s own limitations
Cardiac Rotation Duties (proposal once cardiac MRI at MAHI opens)
1.  Supervise, protocol and review cardiac MRI and CT cases with attending radiologist or cardiologist.  Report appropriate cases after review with attending radiologist or cardiologist. This will occur 3 days per week.
2.  Daily attendance at cardiac reporting in nuclear medicine.
3.  Attend echocardiography 2 days per week.
4.  Resident will aid attending radiologist in preparing imaging for presentation at Adult cardiosurgical or Congenital cardiosurgical conference, attending 2 of each during the rotation.