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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
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
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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.
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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.
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Copyright 2014 Niambi Wellness. All rights reserved
Module 3
Heart Rhythm
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Contents
Chapter 5:
Clinical Significance
Chapter 6:
Examination
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Copyright 2014 Niambi Wellness. All rights reserved
Chapter 5: Clinical Significance
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Contents
Part 1:
Etiology
Part 2:
Answers to Textbook Questions
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Copyright 2014 Niambi Wellness. All rights reserved
Part 1: Etiology
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Without accompanying symptoms, it is
inconclusive to determine that palpitations are
considered significant enough to indicate the
presence of a heart disease.
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The health practitioner must review the complete
patient history and determine whether there are
other cardiovascular symptoms
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Part 1: Textbook Answers
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Answer block
#1
Xin bi
#2
xin ji
#3
xuan yun
#4
septal defects
#5
compensation
#6
mitral functioning
#7
aortic functioning
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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.
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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.
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Answer block
#12
Unusually rapid
rhythm experienced
during exercise or
emotional upset.
#13
Established diagnosis
of coronary artery
disease
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Answer block
#14
Established
diagnosis of
hypertension
#15
Syncope experienced
before or after abrupt
heart rhythm changes.
Copyright 2014 Niambi Wellness. All rights reserved
Copyright 2014 Niambi Wellness. All rights reserved
Chapter 6:Inquiry and Examination
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Contents
Part 1:
Inquiry
Part 2:
Physical Examinations
Part 3:
Cardiac Concerns
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Contents
Part 4:
Vascular Concerns
Part 5:
Auscultation
Part 6:
Answers to text book questions
Copyright 2014 Niambi Wellness. All rights reserved
Copyright 2014 Niambi Wellness. All rights reserved
Part 1:Inquiry and Examination
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When you ask patients about any history of
dizziness or vertigo, listen for special sensations
related to dizziness or the floor rising up.
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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
Copyright 2014 Niambi Wellness. All rights reserved
Part 2: Physical Examination
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The TCM tongue and
pulse examination
may or may not be a
significant to
determine diagnosis.
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Commonly noticed
signs will include a
pale tongue and a
weak and empty
pulse.
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It is necessary to
inspect for any
changes in the
condition.
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These changes
include exterior
syndrome, a
cardiovascular
complication, or other
change including
improvement
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Part 3: Cardiac Concerns
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Palpitations may be a
positive disease sign
if the symptoms are
associated with
cardiovascular
diseases.
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Part 4: Vascular Concerns
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Vascular changes can
be reflected in the
blood pressure
reading as:
Hypertension
Hypotension
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Part 5: Auscultation
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There are two
common types of
tachycardia noticed
with palpitations:
Paroxysmal atrial
fibrillation
Sinus tachycardia
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Copyright 2014 Niambi Wellness. All rights reserved
Part 6: Answers to Textbook Questions
Copyright 2014 Niambi Wellness. All rights reserved
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
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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
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Answer block
#25
caffeine intake
#26
illicit or recreational
drug or alcohol
habits
#27
medications, herbs
and nutritional
supplements for other
health habits
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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
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Answer block
#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
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Answer block
#36
heart failure
#37
pulmonary problems
#38
metabolic disorders
#39
hypertension
Copyright 2014 Niambi Wellness. All rights reserved
Copyright 2014 Niambi Wellness. All rights reserved
Module 3 Review
Questions
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Complete the Module 3
review interactive practice quiz.
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Please continue on to Module 4
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