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Welcome to Cardiovascular Health

Cardiovascular Health (CV)

  • Cardiovascular disease (CVD) remains one of the leading causes of morbidity and mortality in Ireland and globally.(1) (2) It encompasses a range of conditions, including coronary artery disease, heart failure, stroke, hypertension, and peripheral vascular disease. Many of these are preventable or manageable through early detection, lifestyle modification, and evidence-based medical care.

    When considering cardiovascular health, it is important to focus on risk assessment, prevention, diagnosis, and long-term management. As a GP, it is important to address modifiable risk factors such as smoking, diet, physical inactivity, obesity, and hypertension, while also considering the influence of social determinants, mental health, and health inequities.

    General practitioners play a central role in both prevention and continuity of care, working within multidisciplinary teams to support patients through education, medication management, and coordination with specialist services.

    • CV1. Demonstrate competency in assessing, diagnosing, and managing patients with cardiovascular presentations through comprehensive history-taking, physical examination, and interpretation of appropriate diagnostic testing.
    • CV2. Differentiate between cardiac and non-cardiac causes of common symptoms, such as chest pain and breathlessness, to ensure appropriate diagnosis and management.
    • CV3. Utilise cardiovascular risk calculators effectively and communicate results to patients in an understandable and meaningful way.
    • CV4.  Demonstrate proficiency in key clinical and diagnostic skills, including: 
      • Performance and interpretation of ECGs
      • Auscultation of normal and abnormal heart sounds
      • Fluid assessment
      • Urinalysis
      • Fundoscopy
      • Venepuncture
    • CV5. Develop a comprehensive understanding of modifiable and non-modifiable cardiovascular risk factors and their management in primary care.
    • CV6. Effectively apply behaviour change techniques, such as the stages of change model, in managing cardiovascular risk factors, including smoking cessation, weight management, and physical activity.
    • CV7. Deliver holistic, patient-centred care in the management of cardiovascular risk factors, considering the impact of socio-economic and cultural factors while addressing potential personal biases to ensure equitable and culturally sensitive care.
    • CV8. Integrate health promotion and preventative medicine into consultations, demonstrating leadership and communication skills in managing cardiovascular risk.
    • CV9. Advise patients on the impact of cardiovascular conditions on disability, fitness to work, and driving eligibility, ensuring guidance is evidence-based and appropriately communicated.
    • CV10. Coordinate timely referrals to specialist services for acute and hyper-acute cardiovascular presentations, demonstrating a thorough understanding of local referral pathways.

    For each problem or disease, consider the following areas within the general context of primary care:  

    • the natural history of the condition, including whether acute or chronic
    • the incidence and prevalence, including in different demographic groups
    • typical and atypical presentations
    • recognition of normal variations throughout life
    • risk factors, including lifestyle, socio-economic and genetic factors
    • diagnostic features and differential diagnosis
    • recognition of ‘alarm’ or ‘red flag’ features
    • appropriate and relevant investigations
    • interpretation of test results
    • management, including initial and continuing care, chronic disease monitoring and emergency care
    • patient and carer information and education
    • prognosis

    Signs, Symptoms & Presentations

    • Cardiac murmurs
    • Chest pain
    • Circulatory symptoms of ischaemia, thrombosis, chronic arterial and venous insufficiency
    • Collapse
    • Dizziness
    • Dyspnoea
    • Jaw Pain
    • Left Arm Pain
    • Oedema
    • Palpitations and arrhythmias
    • Paroxysmal Nocturnal Dyspnoea
    • Symptoms and signs of stroke or transient ischaemic attack (TIA)
    • Syncope

    Common and Important Conditions

    • Acute Coronary Syndrome
    • Acute Left Ventricular Failure
    • Acute Myocardial Infarction
    • Aortic Stenosis and Regurgitation
    • Arrhythmias
    • Atrial Fibrillation and flutter
    • Atrial Septal Defect
    • Cardiomyopathy
    • Endocarditis
    • Heart Block
    • Heart Failure
    • Hypertension
    • Mitral Stenosis and Regurgitation
    • Myocarditis
    • Patent Ductus Arteriosus
    • Pericarditis
    • Peripheral Vascular Disease
    • Pulmonary Arterial Hypertension 
    • Rheumatic fever
    • Stroke
    • Supraventricular Tachycardia
    • TIA
    • Valvular Heart Disease
    • Ventricular Septal Defect

  • Wherever possible learning resources included here are peer reviewed and externally maintained. This is to ensure that trainees have access to quality assured information that is kept up to date.

    Self-Directed

    Blended Learning Resources (Education Platform)

    Managing Heart Failure in GP

    Prescribing for Hypertension

    Useful Websites

    Life in the fast lane ECG library

    Qrisk 3 – cholesterol risk calculator

    Statin choice decision Aid

    Statin intolerance flow chart GP Notebook

    Irish Heart Foundation – how to keep healthy patient information

    How to interpret a 24hr ABPM

    Blood Pressure Log for Home BP measurements

    European Society for Cardiology Pocket Guidelines

    Anticoagulation Decision Support Tool

    Life in the Fast Lane – ECG Learning Tool

    List of QT prolonging medicine

    Workplace Based Learning

    Workplace-based learning provides essential opportunities to develop practical skills and clinical confidence in managing cardiovascular health. In hospital settings, trainees encounter acute presentations such as myocardial infarction, heart failure, arrhythmias, and stroke, gaining hands-on experience in assessment, urgent management, and use of diagnostic tools like ECGs, troponins, and echocardiography. These rotations also offer insight into multidisciplinary approaches to post-acute care and rehabilitation. In general practice, trainees learn to manage long-term cardiovascular conditions and to deliver preventive care, including lifestyle advice, blood pressure and lipid management, and cardiovascular risk assessment using tools like QRISK. Reviewing and adjusting treatment plans, supporting medication adherence, and building therapeutic relationships over time highlight the key role GPs play in both secondary prevention and holistic care. Through real-world exposure across settings, trainees develop the knowledge, communication skills, and clinical judgement required to manage cardiovascular health effectively across the continuum of care.

    Day Release

    Day release sessions offer an ideal opportunity to explore cardiovascular health in a collaborative and reflective setting. Through case-based discussions, trainees can review common presentations such as chest pain, palpitations, breathlessness, and raised blood pressure, and develop confidence in applying evidence-based guidelines for prevention and management. Topics such as cardiovascular risk assessment, stroke prevention in atrial fibrillation, heart failure management, and secondary prevention after acute coronary syndromes can be discussed in depth. Reviewing ECGs, interpreting blood results, and discussing prescribing choices within peer groups enhances clinical reasoning. These sessions also allow for reflection on barriers to lifestyle change, medication adherence, and health inequalities, helping trainees to strengthen their approach to patient-centred, long-term cardiovascular care.

    Registrar Tutorials

    Registrar tutorials provide a focused environment to consolidate learning around cardiovascular health, tailored to the trainee’s current clinical experience. These sessions can involve reviewing recent cases, such as new-onset atrial fibrillation, uncontrolled hypertension, or medication optimisation in heart failure. With trainer support, trainees can refine their clinical reasoning, discuss investigation and referral pathways, and address challenges in risk communication or shared decision-making. Tutorials also offer the opportunity to practise ECG interpretation, review prescribing considerations (e.g., statins, anticoagulants), and explore the role of primary care in post-discharge follow-up. Through these personalised discussions, trainees develop confidence in managing both acute and chronic cardiovascular conditions within the community.

  • Entrustable Professional Activities (EPAs) underpin workplace-based assessment in this curriculum. Each EPA represents an integrated clinical task that General Practitioners must perform safely and independently, assessed through direct or indirect observation in real clinical settings.

    The curriculum and EPA framework are closely aligned: the curriculum defines the required knowledge, skills, and professional behaviours, while EPAs assess their application in practice. Together, they create a coherent approach to developing and demonstrating readiness for independent clinical work.

    The examples show how specific activities within general practice & chapters of the curriculum align with particular EPAs.

    EPA 11: Manage the health promotion and preventive health needs of adults, including older people

    EPA 11 could be used to record a consultation discussing modifiable cardiovascular risk factors and develop a tailored management plan incorporating behaviour change techniques such as motivational interviewing. Reflection may cover how to integrate health promotion into time-limited consultations.

    Core Knowledge Test (CKT)

    • How to manage new onset atrial fibrillation
    • Medical Management of Hypertension.
    • Assessment of chest pain. 

    Clinical Competency Test (CCT)

    • A patient with progressive shortness of breath on exertion.
    • A patient with chest tightness when walking uphill lately.
    • A patient with what appears to be new onset Atrial Fibrillation on ECG.

    Disclaimer: The examples provided within this section are intended to be indicative only and are included to illustrate how elements of the curriculum may be assessed in the Clinical Competency Test (CCT).

    Examination questions in the CCT test the ability of candidates to integrate knowledge, skills, and professional behaviours across multiple curriculum areas to address the challenges posed by the question.

    The indicative content should therefore be used solely as a general guide as to some of the topics that may be introduced. Actual examination questions will assess a greater depth and complexity of understanding than the illustrative examples provided.

    Please note that a number of CCT questions will require candidates to undertake a physical examination of the simulated patient. In some circumstances, for example in the case of an intimate examination, candidates may be required to display their examination skills through use of a manikin or other device.

    1. Cardiovascular diseases [Internet]. [cited 2025 July 21]. Available from: https://www.who.int/health-topics/cardiovascular-diseases.
    2. Vital Statistics Yearly Summary 2021 - CSO - Central Statistics Office [Internet]. CSO; 2022 [cited 2025 July 21]. Available from: https://www.cso.ie/en/releasesandpublications/ep/p-vsys/vitalstatisticsyearlysummary2021/