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

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

3. 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

5. 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 Course Description

6. 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

8. Module 3 Heart Rhythm Copyright 2014 Niambi Wellness. All rights reserved

9. Chapter 5: Clinical Significance Chapter 6: Examination Contents Copyright 2014 Niambi Wellness. All rights reserved

11. Chapter 5: Clinical Significance Copyright 2014 Niambi Wellness. All rights reserved

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

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

15. Without accompanying symptoms, it is inconclusive to determine that palpitations are considered significant enough to indicate the presence of a heart disease. Copyright 2014 Niambi Wellness. All rights reserved

16. The health practitioner must review the complete patient history and determine whether there are other cardiovascular symptoms Copyright 2014 Niambi Wellness. All rights reserved

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

18. Answer block #1 Xin bi #2 xin ji #3 xuan yun #4 septal defects #5 compensation #6 mitral functioning #7 aortic functioning Copyright 2014 Niambi Wellness. All rights reserved

19. Answer block #8 anxiety and depression #9 at rest, while sleeping, and moving from sitting to standing position #10 The history can provide useful information such as rhythm quality. Copyright 2014 Niambi Wellness. All rights reserved

20. Answer #11 S: Irregular rhythms: Paroxysmal atrial fibrillation and normal sinus Regular rhythms: Paroxysmal supraventricular and sinus tachycardia D: The rhythm patterns are either regular, irregular and/or increase abruptly with different terminations. Copyright 2014 Niambi Wellness. All rights reserved

21. Answer block #12 Unusually rapid rhythm experienced during exercise or emotional upset. #13 Established diagnosis of coronary artery disease Copyright 2014 Niambi Wellness. All rights reserved

22. Answer block #14 Established diagnosis of hypertension #15 Syncope experienced before or after abrupt heart rhythm changes. Copyright 2014 Niambi Wellness. All rights reserved

24. Chapter 6:Inquiry and Examination Copyright 2014 Niambi Wellness. All rights reserved

25. Part 1: Inquiry Part 2: Physical Examinations Part 3: Cardiac Concerns Contents Copyright 2014 Niambi Wellness. All rights reserved

26. Part 4: Vascular Concerns Part 5: Auscultation Part 6: Answers to text book questions Contents Copyright 2014 Niambi Wellness. All rights reserved

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

29. When you ask patients about any history of dizziness or vertigo, listen for special sensations related to dizziness or the floor rising up. Copyright 2014 Niambi Wellness. All rights reserved

30. In Chinese medicine, tachycardia is often differentiated as blood stagnation and qi and yin deficiency. Bradycardia is usually differentiated as blood stasis which blocks the heart vessel, phlegm, yang deficiency, cold, and dampness. Copyright 2014 Niambi Wellness. All rights reserved

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

33. The TCM tongue and pulse examination may or may not be a significant to determine diagnosis. Copyright 2014 Niambi Wellness. All rights reserved

34. Commonly noticed signs will include a pale tongue and a weak and empty pulse. Copyright 2014 Niambi Wellness. All rights reserved

35. It is necessary to inspect for any changes in the condition. Copyright 2014 Niambi Wellness. All rights reserved

36. These changes include exterior syndrome, a cardiovascular complication, or other change including improvement Copyright 2014 Niambi Wellness. All rights reserved

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

38. Palpitations may be a positive disease sign if the symptoms are associated with cardiovascular diseases. Copyright 2014 Niambi Wellness. All rights reserved

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

40. Vascular changes can be reflected in the blood pressure reading as: Hypertension Hypotension Copyright 2014 Niambi Wellness. All rights reserved

41. Part 5: Auscultation Copyright 2014 Niambi Wellness. All rights reserved

42. There are two common types of tachycardia noticed with palpitations: Paroxysmal atrial fibrillation Sinus tachycardia © Copyright 2012 Niambi Wellness. All rights reserved

43. Copyright 2014 Niambi Wellness. All rights reserved

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

45. Answer block #16 history and health diary can help rule out emotional or cardiac causes #17 Do beats feel like pounding and fluttering, skipping beats or racing? #18 Can you tap out a rhythm during an episode? #19 Family or personal history during an arrythmia Copyright 2014 Niambi Wellness. All rights reserved

46. Answer block #20 history of heart problems #21 fever or other febrile illnesses or diseases #22 history of chest pain and dyspnea #23 history of ischemia or myopathy #24 emotional state and any medications, herbs or supplements which improve it Copyright 2014 Niambi Wellness. All rights reserved

47. Answer block #25 caffeine intake #26 illicit or recreational drug or alcohol habits #27 medications, herbs and nutritional supplements for other health habits Copyright 2014 Niambi Wellness. All rights reserved

48. Answer block #28 Tapping the rhythm which can be confirmed by the patient, or observing abnormal chest movement #29 tapping can be done by the patient and confirmed by the health practitioner Copyright 2014 Niambi Wellness. All rights reserved

49. #30 EKG will reflect changes in the sinus node rate, muscle tissue contractility, atrial and ventricular contraction #31 hypertension #32 artery and valvular diseases #33 respiratory diseases #34 endocrine disorders #35 psycho-emotional issues Copyright 2014 Niambi Wellness. All rights reserved Answer block

50. #36 heart failure #37 pulmonary problems #38 metabolic disorders #39 hypertension Copyright 2014 Niambi Wellness. All rights reserved Answer block

51. Copyright 2014 Niambi Wellness. All rights reserved

52. Module 3 Review Questions

53. Complete the Module 3 review interactive practice quiz. Copyright 2014 Niambi Wellness. All rights reserved

54. Please continue on to Module 4 Copyright 2014 Niambi Wellness. All rights reserved