There is but a handful of medical disciplines in which understanding of basic physiology is critical to recognising the clinical manifestations of disease. Cardiology is a paramount example of such a symbiosis. This multimedia, interactive e-learning resource makes no apology for being less than all-inclusive. Rather, its major aim is to enable the learner to conceptualise an approach to the clinical diagnosis and management of cardiac patients based on sound principles of applied physiology. Contained herein are ten chapters – each offering a unique challenge to apply these principles in the setting of individual case scenarios covering a wide array of cardiac conditions.

The chapters should flow smoothly. Each begins with a brief story of the clinical presentation. A decision point is then reached - represented in the form of multiple options – directions, if you will, on how to proceed. Each of your responses, whether correct or not, is positively reinforced with feedback designed to illustrate how applied physiology facilitates the diagnosis and rationalises an approach to management - always mindful of the patient’s anticipated reaction, needs and preferences. Your clinical responsibility never wavers as your patient stumbles through a branching network of different circumstances, each posing a different set of options. The narrative is occasionally highlighted with animated images - a visual framework to help understand the mechanisms of disease processes and how they manifest clinically.

You should have fun. Get started by clicking on the Table of Contents tab above.

Produced under the auspices of The Division of Cardiology, The Division of e-Learning Innovation, Faculty of Health Sciences, McMaster University and The Population Health Research Institute Hamilton Health Sciences

Unlike conventional print textbooks an e-learning resource calls for a different consortium of players. An apt analogy would be the production of a musical album. Where would Johnny Mercer the prolific lyricist be without a Harold Arlen as composer or Bono without Brian Eno and Daniel Lanois as musical arrangers. Apropos, my humble narrative is highlighted by the creative artistry of Ed Mallon. The instructional design and arrangement of the whole - skilfully orchestrated by Dr. Anthony Levinson. The technical wizardry underlying the e-learning classroom would not have been possible without John Bousfield's programming verve. Special thanks go to Jodie Bousfield for her expert line editing. I am indebted to Dr. Omid Salehian for his advice and valuable resource contributions. To Drs Salim Yusuf and Stuart Connelly I owe thanks for their encouragement and support. This production would not have been possible without the generous funding support from the Population Health Research Institute, the Alex Numbers Fund, and the Faculty of Health Sciences, McMaster University.

The concepts in this book were handed down to me by my teachers who have served as inspirational guides throughout my professional life. The list is long but special mention goes to Richard Gorlin, Arnold Johnson, Maurice McGregor, Alberto Malliani, Peter Sleight and David Stubington.

I especially thank my wife Helene who kept goading me to do something with all the scraps of paper lying around.

Finally, to all those students who had the gall to challenge me with penetrating questions, this book is dedicated.

- Ernest L. Fallen MD FRCP (C)