Learning Objectives:

• Differentiate types of myocardial injury and infarction using contemporary high-sensitivity troponin strategies and clinical context.
• Apply guideline-directed medical and interventional strategies in the acute and post-acute management of patients with acute coronary syndromes.
• Recognize patient-specific factors that influence antithrombotic therapy selection, duration, and bleeding risk following ACS.

Chad A. Link, DO, FACC, FACOI, Cardiologist, University of Michigan Health- Sparrow

Learning Objectives:

• Identify key clinical and echocardiographic features used to assess severity and timing of intervention in common valvular heart diseases.
• Recognize high-risk findings that warrant early referral for structural heart evaluation prior to the development of symptoms.
• Apply evidence-based principles to the diagnosis and longitudinal management of patients with valvular and congenital heart disease in internal medicine practice.

Chad A. Link, DO, FACC, FACOI, Cardiologist, University of Michigan Health- Sparrow

Learning Objectives:

• Identify clinical features and diagnostic strategies for peripheral arterial disease, including appropriate use of ankle-brachial and toe-brachial indices.
• Recognize peripheral arterial disease as a manifestation of systemic atherosclerosis associated with increased cardiovascular risk.
• Apply contemporary guideline-directed medical, antithrombotic, and lifestyle-based therapies to reduce cardiovascular and limb-related adverse outcomes.

Chad A. Link, DO, FACC, FACOI, Cardiologist, University of Michigan Health- Sparrow

Educational Objectives for a Lecture on Management of Cardiac Arrhythmias and Conduction Disorders Based on the 2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation and the 2022 ESC Guidelines for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death, these objectives are tailored for medical students, residents, or practicing clinicians. 

By the end of this lecture, participants will be able to: 

• Describe the pathophysiological mechanisms underlying atrial fibrillation (AF), including electrophysiological abnormalities such as ectopic action potentials from pulmonary veins and reentrant activity due to interstitial fibrosis, and explain how cardiovascular risk factors like obesity contribute to increased AF risk. 
• Identify the top 10 take-home messages from the 2023 AF guidelines, such as viewing AF as a disease continuum requiring prevention strategies, lifestyle modifications, and early rhythm control to minimize AF burden and adverse outcomes. 
• Apply risk stratification tools, including the CHA2DS2-VASc score and consideration of stroke risk modifiers (e.g., blood pressure control), to determine annual thromboembolic event risk in patients with AF and guide anticoagulation decisions for those at intermediate to low risk (<2%). 
• Evaluate the Class 1 recommendations for catheter ablation in AF management, including its use as first-line therapy in selected patients and in those with heart failure with reduced ejection fraction, citing evidence from randomized studies demonstrating superiority over drug therapy. 
• Recommend updated strategies for device-detected AF in patients with implantable devices or wearables, considering episode duration and underlying thromboembolic risk to provide prescriptive anticoagulation guidance. 
• Analyze the upgraded Class 2a recommendation for left atrial appendage (LAA) occlusion devices in patients with long-term contraindications to anticoagulation, incorporating safety and efficacy data to balance stroke prevention with bleeding risks. 
• Develop management plans for AF identified during medical illness, surgery, or other precipitants, emphasizing the risk of recurrent AF and post-illness monitoring to prevent complications. 
• Compare recommendations for rhythm monitoring tools (e.g., wearable devices) and risk-based selection of oral anticoagulation, balancing benefits and risks in specific populations such as those with AF complicating acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI). 
• Differentiate between periprocedural anticoagulation management strategies for patients with AF undergoing procedures, including when to interrupt or continue therapy based on bleeding and thrombotic risks. 
• Summarize key aspects of long-term rate control in AF using beta blockers or non-dihydropyridine calcium channel blockers, and outline prevention strategies for ventricular arrhythmias and sudden cardiac death from the 2022 ESC guidelines, focusing on patient management in high-risk groups.

Robert J. Chilton, DO, MACOI, Professor of Medicine, University of Texas Health Science Center

Learning Objectives:

• Educational Objectives for a Module on Stable Ischemic Heart Disease (SIHD) and Chronic Coronary Disease Management Based on the 2023 AHA/ACC/ACCP/ASPC/NLA/PCNA Guideline for the Management of Patients With Chronic Coronary Disease, these objectives are designed for medical students, residents, or healthcare professionals. 

By the end of this module, learners will be able to: 

• Describe the key pathophysiological principles of SIHD, including the balance of myocardial oxygen supply and demand, the Law of Laplace, and the ischemic cascade, using diagrams and examples from clinical guidelines. 
• Identify at least five major take-home messages from the 2023 guidelines on chronic coronary disease, such as the emphasis on nonpharmacologic therapies like diet, exercise, and cardiac rehabilitation, and explain their role in reducing morbidity and mortality. 
• Compare the Class of Recommendation (COR) and Level of Evidence (LOE) for diagnostic evaluations in patients with chronic coronary disease, including when to use stress imaging (e.g., PET/SPECT MPI) versus invasive coronary angiography for guiding treatment in symptomatic patients despite guideline-directed medical therapy (GDMT).
• Apply risk stratification tools to classify patients with chronic coronary disease as low, intermediate, or high risk for major adverse cardiovascular events (MACE), incorporating noninvasive testing results and validated scores to inform treatment decisions. 
• Evaluate the potential adverse cardiovascular effects of substances with abuse potential (e.g., alcohol, cocaine, opioids, marijuana) in patients with chronic coronary disease, and recommend strategies to mitigate risks based on guideline evidence. 
• Recommend appropriate lipid management strategies for patients with chronic coronary disease, including high-intensity statin therapy aiming for ≥50% LDL-C reduction, and adjunctive therapies like ezetimibe or PCSK9 inhibitors in select high-risk populations, while assessing adherence through periodic lipid measurements. 
• Develop a blood pressure management plan for patients with chronic coronary disease and hypertension, targeting <130/80 mm Hg using nonpharmacologic strategies first and GDMT agents like ACE inhibitors, ARBs, or beta blockers as primary pharmacologic options. 
• Select SGLT2 inhibitors or GLP-1 receptor agonists for patients with chronic coronary disease and comorbidities such as type 2 diabetes, chronic kidney disease (CKD), or heart failure with LVEF ≤40%, justifying their use based on evidence for reducing MACE and improving quality of life. 
• Differentiate between antiplatelet therapy regimens for patients with chronic coronary disease, including low-dose aspirin for primary prevention and dual antiplatelet therapy (DAPT) post-PCI, while considering shorter durations to balance ischemic and bleeding risks. 
• Analyze the indications for revascularization in patients with chronic coronary disease, such as CABG over PCI in those with diabetes and multivessel disease or left main involvement, using trial data (e.g., FREEDOM trial) to support decisions on improving survival and reducing repeat procedures.

Robert J. Chilton, DO, MACOI, Professor of Medicine, University of Texas Health Science Center

Learning Objectives:

• Upon completion, participant will be able to identify the core components of guideline-directed medical therapy (GDMT) for HFrEF and summarize the evidence-based benefits of each major drug class, including ACEi/ARB/ARNI, beta-blockers, MRAs, and SGLT2 inhibitors.
• Upon completion, participant will be able to apply GDMT principles to common clinical scenarios by selecting appropriate therapies, adjusting doses, and recognizing contraindications or monitoring parameters in patients with CHF.
• Upon completion, participant will be able to describe the pathophysiology, clinical presentation, and classification of congestive heart failure, including distinctions between HFrEF and HFpEF.

Arash Karnama, DO, FACOI, Clinical Associate Professor of Medicine, Oklahoma State University

Learning Objectives:

• Recognize common EKG patterns seen in primary care.
• Distinguish between benign variants from concerning findings.
• Identify when reassurance is appropriate vs when further evaluation is needed.

David J. Strobl, DO, FNLA, Professor, Michigan State University

Learning Objectives:

• Define “Cardiomyopathy” and differentiate its various classifications.
• Describe the pathophysiology, presenting symptoms, physical exam, and diagnostic findings of the specific cardiomyopathies.
• Discuss the treatment of specific cardiomyopathies.

David J. Strobl, DO, FNLA, Professor, Michigan State University

Learning Objectives:

• Recognize life-threatening electrolyte abnormalities and correlate laboratory values with ECG and clinical findings. Apply evidence-based management strategies for severe electrolyte emergencies, including indications for IV therapy, cardiac monitoring, and dialysis.
• Identify common iatrogenic and medication-related causes of electrolyte disturbances in hospitalized and ICU patients.
• Anticipate and prevent refractory electrolyte disorders, particularly hypokalemia due to concomitant hypomagnesemia

Anis Rauf, DO, Physician, NANI

Learning Objectives:

• Identify current screening and diagnostic tests in evaluating a patient with kidney disease
• Discuss the pathophysiology and cardiovascular comorbidity in chronic kidney disease and the effect of lifestyle modification in the treatment of chronic kidney disease
• Review current individualized pharmacological treatments to slow the progression of chronic kidney disease and the associated metabolic complications

Mark D. Baldwin, DO, MACOI, FASN (he/him/his), Professor of Internal Medicine, Nephrology & Hypertension, ACOI

Learning Objectives:

• Describe the current epidemiology, common risk factors, and potential complications associated with kidney stone disease.
• Identify and explain established dietary and pharmacological interventions for the prevention of various kidney stone types.
• Evaluate the emerging evidence for Sodium-Glucose Co-transporter 2 inhibitors (SGLT2i) as an off-label adjunctive therapy for kidney stone prevention.

David S. Levy, DO, FACOI, FASN (he/him/his), Assistant Professor of Clinical Medicine, University of Rochester School of Medicine

Learning Objectives:

• Refresh your knowledge of normal renal sodium physiology.
• Apply appropriate criteria to distinguish acute from chronic hyponatremia and determine the need for emergent intervention in patients presenting with hyponatremia.
• Implement evidence-based treatment protocols for acute symptomatic hyponatremia, including appropriate hypertonic saline dosing and correction targets.

Tarra I. Faulk, DO, FASN, CPE (she/her/hers), Staff Nephrologist, Brooke Army Medical Center

Learning Objectives:

• Review to roles of patient & family education in the care of a patient with chronic kidney disease
• Describe proper care for vascular or peritoneal dialysis access or care of the proposed limb for future vascular access.
• Recognize common complication of hemo and peritoneal dialysis modalities

Mark D. Baldwin, DO, MACOI, FASN (he/him/his), Professor of Internal Medicine, Nephrology & Hypertension, ACOI

Learning Objectives:

• Highlight the prevalence of herbal and alternative medicine use.
• Describe the nephrotoxic effects of common herbal supplements.
• Describe the nephrotoxic effects of common alternative and traditional medicines.

Nicholas Salupo, DO

Learning Objectives:

• Provide a framework for evaluation of kidney dysfunction in the setting of cancer treatment.
• Describe common classes of cancer therapeutics and their impact on the kidney.
• Describe common renal manifestation of a variety of malignancies.

Nicholas Salupo, DO