General Goals: nuclear cardiology training requires an understanding of cardiovascular pathology, physiology, and anatomy. These methods provide important diagnostic and prognostic information. As a first or second year fellow, the 2 months required in this area is designed to provide the general (level I) training necessary for a clinical cardiologist to understand the role of nuclear cardiology and cardiac CT in general clinical practice. This rotation will serve to allow the fellow to achieve competence in stress testing procedures. As an elective (additional months in the 2nd or 3rd year), the primary goal of this rotation is to achieve level 2 or 3 competency in nuclear cardiology.
- Know indications for myocardial perfusion imaging and the appropriate selection of exercise versus pharmacologic stress.
- Know how to evaluate pre-test and post-test probability
- Know the indications, risks, and contraindications for stress testing (both for diagnosis and risk stratification).
- Know common exercise test protocols.
- Know ECG and hemodynamic for stopping a test and defining high risk.
- Know the limitations of exercise ECG alone, and the potential utility of adding imaging.
- Identify results that indicate a high risk state.
- Skill to select appropriate stress type and exercise protocol for diverse patient types.
- Incorporate appropriate use criteria, risk-benefit, and cost considerations in the use of stress testing and cardiac radionuclide procedures.
- Work effectively with nuclear cardiology laboratory staff.
- Know principles of image acquisition and display, including standard tomographic views.
- Know properties of perfusion tracers.
- Know principles of radiation safety.
- Know mechanisms of pharmacologic stress agents, proper use, and safety issues.
- Integrate nuclear imaging findings with other clinical data for evaluation and management of patients.
- Skill to safely perform stress testing (both exercise and pharmacologic).
- Skill to identify and treat complications from stress testing.
- Integrate all data from stress testing for risk assessment.