Vancouver SCAD Conference 2023

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4 Videos

Run time around 12 Hours

What is SCAD?

Spontaneous Coronary Artery Dissection (SCAD) is a life-threatening condition where a tear occurs in the arterial wall of the heart. This tear blocks blood flow and causes a heart attack, sudden cardiac arrest and sometimes death. SCAD can affect otherwise healthy young to middle-age women. Further research is necessary to understand how to best manage and investigate this disease.

Agenda for 2023

Saturday May 6/2023:

• Registration & Lunch
• Welcome & Opening Remarks (Saw)

Introduction & Overview of Heart Disease in Women: Chair – Saw

• Keynote: Spectrum of heart disease in women (Gulati)
• Keynote: What have we learnt from MI histopathology in women (Virmani)
• Overview of COVID-19 impact on MI outcomes (Henry)
•  Causes of MINOCA & investigation algorithm (Sedlak)
•  Causes of INOCA, investigation & management (Toleva)
• Panel/Audience Q&A: Saw, Gulati, Virmani, Henry, Sedlak, Toleva

SCAD: Epidemiology & Predisposing Causes: Chair – Gulati

•  History and epidemiology of SCAD (Mulvagh)
•  Update on the genetic basis of SCAD (Ganesh)
• Rapid fire overview and update of FMD (Kim)
• Link between FMD and SCAD (Kim)
•  Link between hereditary connective tissue disorders & SCAD (Ganesh)
• Link between pregnancy & SCAD (Wood)
• Panel/Audience Q&A: Saw, Gulati, Mulvagh, Ganesh, Kim, Wood, Virmani

SCAD: How Do Patients Present? Chair – Wood

• Emotional stress as a trigger for SCAD (Tulloch)
•  Physical activity as a trigger for SCAD (Yang)
• Other triggers like sneezing, retching, hormones, cocaine? (Tremmel)
•  Clinical presentation with SCAD, women vs men? (Lavoie)
• Is there a link between inflammation & SCAD? (Scott)
•  Acute hospital presentation with SCAD (Chou)
•  Panel/Audience Q&A: Saw, Wood, Tulloch, Tremmel, Lavoie, Aymong, Chou, Scott

Challenging SCAD Cases Session 1: Chair – Lavoie & Asgar (5min case, 5min discussion) (Session for medical professionals only)

• Challenging case #1 (Toleva)
• Challenging case #2 (Wood)
• Challenging case #3 (Madan)
• Day 1 Wrap-Up: Saw

Saturday Afternoon Patient Break-out Sessions: Q&A Discussions

Saturday May 6/2023

Genetics in Families with SCAD: Chair – Santhi Ganesh & Jungin Choi

•  Genetic basis of SCAD
• Families with SCAD
• Available genetic studies

Cardiac Rehabilitation after SCAD: Chair – Taira Birnie (VGH SCAD Rehab) & Cathevine Yang

• When can you start exercising post-SCAD?
• What exercises can you be involved with post-SCAD?
• What activities should you avoid post-SCAD?

Sunday May 7/2023

•  Breakfast & registration

Challenging SCAD Cases Session 2: Chair – Asgar & Toleva (5min case, 5min discussion)

• (Session for medical professionals only)
• Challenging case #4 (Henry)
• Challenging case #5 (Lavoie)
• Challenging case #6 (Tremmel)

SCAD: Diagnosis & Acute SCAD Management: Chair – Virmani

•  Diagnosis of SCAD on coronary angiography (Saw)
• When, which, and how to use intracoronary imaging for SCAD (Fung)
• Diagnosis and follow-up of SCAD on cardiac CT (Nicolaou)
• Management decisions with SCAD: conservative vs invasive (Madan)
• PCI strategies with SCAD (Saw)
• CABG strategy with SCAD (Skarsgard)
• Cardiogenic shock & use of mechanical support with SCAD (Asgar)
• Panel/Audience Q&A: Saw, Virmani, Fung, Nicolaou, Madan, Skarsgard, Asgar, Henry

SCAD: Long-term Management: Chair – Henry

• What are the risks of pregnancy after a SCAD event? (Scott)
• Screening for FMD & vascular disorders after SCAD (Kim)
• Which SCAD patients should undergo clinical genetic screening? (Ganesh)
• In-hospital & long-term outcomes post-SCAD (Lavoie)
• Medical management of SCAD patients (Ramanathan)
• Panel/Audience Q&A: Saw, Henry, Lavoie, Ramanathan, Ganesh, Kim

Controversies in SCAD Management: Chair – Madan

• Left main SCAD, how should we manage? (Henry)
• Role of hormonal replacement therapy post-SCAD? (Tremmel)
• Recurrent chest pains post-SCAD & how to investigate/manage (Sedlak)
• Cardiac arrest presentation with SCAD, when is ICD required? (Andrade)
• Panel/Audience Q&A: Saw, Madan, Andrade, Sedlak, Olin, Tremmel, Toleva

Improving healthcare delivery for SCAD patients: Chair – Tremmel

• How should general/nurse practitioners manage SCAD patients after discharge, before they are seen by specialists? (Madan)
• Strategies to raise awareness to mitigate SCAD underdiagnosis (Mulvagh)
• How to test for microvascular dysfunction post-SCAD (Toleva)
• Exercise rehabilitation and physical activities post-SCAD (Birnie)
• Panel/Audience Q&A: Saw, Tremmel, Andrade, Madan, Mulvagh, Toleva

Life After SCAD & Patient Perspectives: Chair – Mulvagh

•  Depression, migraines & anxiety in patients with SCAD (Pittman-Wagers)
•  Psychosocial issues, challenges and needs post-SCAD (Tulloch)
•  Patient experience #1
•  Patient experience #2
•  Patient experience #3
•  Panel/Audience Q&A: Saw, Mulvagh, Pittman-Wagers, Tulloch, Madan, Lavoie, Toleva
•  Conference Wrap-Up & Meeting Adjourn: Saw

Sunday Morning Patient Break-out Sessions: Q&A Discussions
Sunday May 7/2023

Fibromuscular Dysplasia Workshop for Patients: Chair – Pam Mace (FMDSA), Kim & Olin

•  What is FMD?
• Link between FMD and SCAD
• Living with FMD

Chest Pain After SCAD: Chair – Tara Sedlak & Nandita Scott

• How often is chest pain post-SCAD?
• When should testing be done, and which tests?
• How to manage chest pain post-SCAD?

Psychosocial Issues after SCAD: Chair – Heather Tulloch & Pittman-Wagers

• Balancing work, family, life post-SCAD
• Social media & web supports with SCAD
• Psychosocial support after SCAD

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