108 - #HERHEARTMATTERS: CARDIO-OBSTETRICS: IMPROVING THE CARE OF THE PREGNANT PATIENT WITH CARDIOVASCULAR DISEASE

Thursday, October 27, 2022

11:00 AM – 11:45 AM EDT

Location: Canada Hall 1

Target Audience: General: All cardiovascular (clinical and research) health professionals, Trainee (clinical), Trainee (research)

Co-Chair(s)

Jasmine Grewal, MD

Clinical Professor
University of British Columbia
University of British Columbia
Vancouver, British Columbia, Canada
Thais Coutinho, MD (she/her/hers)

Chief, Division of Cardiac Prevention and Rehabilitation
University of Ottawa Heart Institute
University of Ottawa Heart Institute
Ottawa, Ontario, Canada
Habibat Garuba

Cardiologist and Assistant Professor
The Ottawa Hospital / University of Ottawa Heart Institute
University of Ottawa Faculty of Medicine
Ottawa, Ontario, Canada

Planning Committee Member(s)

SJ

Shahin Jaffer, MD, MHSc, FRCPC

Clinical Professor of Medicine, University of British Columbia
Vancouver, British Columbia, Canada
Kiera Liblik, BSc(H)

Medical Student; Master's Student
Queen's University, School of Medicine/Translational Medicine Graduate Program
Kingston, Ontario, Canada
Shuangbo Liu, MD, FRCPC

Interventional Cardiologist/Assistant Professor
St. Boniface Hospital/University of Manitoba
St. Boniface Hospital, University of Manitoba
Winnipeg, Manitoba, Canada
M. Patrice Lindsay

Director, Health Systems Change
Heart and Stroke Foundation of Canada
Toronto, Ontario, Canada
MM

Martha Mackay, PhD, RN, CCN(C)

Clinical Associate Professor/Clinical Nurse Specialist
CCCN
Vancouver, British Columbia, Canada
Kelsey McLaughlin, PhD

Research Associate
CCS
Sinai Health System
Toronto, Ontario, Canada
MN

Meagan Noble, MN, NP-Adult

Nurse Practitioner, Indigenous Services Canada
Toronto, Ontario, Canada
Nazli Parast, EdD (c), MN, BScN, RN, CDE

RN
University of Ottawa Heart Institute
Ottawa, Ontario, Canada
RP

Robin Pohl, BPE, ACSM-CEP

Cardiac Rehab Exercise Therapist
CACPR
Burlington, Ontario, Canada
Harriette Van Spall, MD, MPH, FRCPC (Cardiology)

Associate Professor of Medicine
McMaster University
Hamilton Health Sciences
Hamilton, Ontario, Canada

Disclosure(s):

Thais Coutinho, MD: No financial relationships to disclose

Habibat A. Garuba: No relevant disclosure to display

Laura Avelar, n/a: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Laurie-Anne Boivin-Proulx: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Amy Johnston: No financial relationships to disclose

Amélie Paquin, MD MSc: No financial relationships to disclose

Shahin Jaffer, MD, MHSc, FRCPC: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Kiera Liblik, BSc(H): I do not have any relevant financial / non-financial relationships with any proprietary interests.

Shuangbo Liu, MD, FRCPC: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Martha Mackay, PhD, RN, CCN(C): I do not have any relevant financial / non-financial relationships with any proprietary interests.

Kelsey McLaughlin, PhD: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Meagan Noble, MN, NP-Adult: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Nazli Parast, EdD (c), MN, BScN, RN, CDE: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Robin Pohl, BPE, ACSM-CEP: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Harriette Van Spall, MD, MPH, FRCPC (Cardiology): No financial relationships to disclose

Learning Objectives:

At the conclusion of this session, participants will be able to:

define the scope of cardio-obstetrics and discuss the importance of a pregnancy heart team;
describe current challenges and gaps in cardio-obstetrics care, including the impact of social determinants of health (e.g., race, ethnicity, socioeconomic factors) and identify strategies to bridge these gaps; and
identify current initiatives and available resources for patients and health care professionals in the field of cardio-obstetrics.

Cardiovascular disease (CVD) is the number one killer of Canadian women and one of the leading causes of maternal mortality in North America. The prevalence of CVD in women of childbearing age is increasing, due to higher survival rates of patients with pediatric / congenital heart disease into their reproductive years, older maternal age at first pregnancy, and higher prevalence of underlying CVD risk factors in pregnant women. Furthermore, complications of pregnancy, such hypertensive disorders of pregnancy (e.g., pre-eclampsia), are associated with a significantly higher risk of premature CVD and other adverse outcomes in women.

Cardio-obstetrics is an emerging subspecialty of cardiology, focusing on prevention, early detection, and appropriate management of CVD from pre-conception through the postpartum period. Despite the critical importance of cardiovascular health in pregnancy, women and health care professionals remain unaware of the acute and long-term cardiovascular complications of pregnancy, baseline cardiovascular conditions of concern in women considering pregnancy, feto-maternal cardiovascular complications, and appropriate maternal cardiovascular screening and follow up. Moreover, substantial disparities and obstacles exist in accessing cardio-obstetric care among Canadian women across the country.

In this workshop, members of the Canadian Women’s Heart Health Alliance (CWHHA) will address the purpose and goals of a cardio-obstetric program, its associated geographic, ethical and cultural challenges, potential keys to bridging these gaps, and current initiatives and resources available in Canada.

We will do this by using the outline below:

- Ms. Laura Avelar will provide a valuable patient perspective by sharing her unique heart story.

- Dr. Habibat Garuba will give an overview of the scope of cardio-obstetrics, and cardiovascular physiology during pregnancy, labour, delivery, and post-partum. She will discuss maternal cardiac risk assessment tools, diagnostic imaging considerations, medication safety, and the importance of a multidisciplinary pregnancy heart team.

- Dr. Laurie-Anne Boivin-Proulx will provide insight into the geographical barriers to accessing cardio-obstetric care in Canada, and ethical considerations in situations in which pregnancy is contraindicated.

- Ms. Amy Johnston will describe key socio-demographic determinants of cardio-obstetric health, and outline recommendations to address disparities in cardio-obstetric care and delivery.

- Finally, Dr. Amélie Paquin will speak to initiatives that are currently underway in Canada, available programs and services, and practical takeaways and resources for women and healthcare professionals.

Presentations:

11:00 AM – 11:03 AM EDT

WELCOME & INTRODUCTION
11:03 AM – 11:05 AM EDT

CANADIAN WOMEN'S HEART HEALTH ALLIANCE OVERVIEW
Presenter: Najah Adreak – The university of British Columbia/ BC Chidren Hospital
11:05 AM – 11:10 AM EDT

MY HEART STORY
Presenter: Laura Avelar, n/a
11:10 AM – 11:17 AM EDT

WHAT IS CARDIO-OBSTETRICS AND WHY DO WE NEED IT?
Co-Chair: Habibat A. Garuba – The Ottawa Hospital / University of Ottawa Heart Institute
11:17 AM – 11:26 AM EDT

CHALLENGES AND GAPS IN CARDIO-OBSTETRICS CARE AND DELIVERY
Presenter: Laurie-Anne Boivin-Proulx – University Of Montreal
11:26 AM – 11:31 AM EDT

THE FUTURE CARE OF PREGNANCY & HEART DISEASE, RECOMMENDATIONS AND PRACTICAL TAKEAWAYS
Presenter: Amélie Paquin, MD MSc (she/her/hers) – University of Ottawa Heart Insittute
11:31 AM – 11:43 AM EDT

DISCUSSION
Chair: Jasmine Grewal, MD – University of British Columbia
Co-Chair: Thais Coutinho, MD (she/her/hers) – University of Ottawa Heart Institute
Co-Chair: Habibat A. Garuba – The Ottawa Hospital / University of Ottawa Heart Institute
Presenter: Laura Avelar, n/a
Presenter: Najah Adreak – The university of British Columbia/ BC Chidren Hospital
Presenter: Laurie-Anne Boivin-Proulx – University Of Montreal
Presenter: Amy Johnston – University of Ottawa Heart Institute
Presenter: Amélie Paquin, MD MSc (she/her/hers) – University of Ottawa Heart Insittute
11:43 AM – 11:45 AM EDT

CLOSING REMARKS
Chair: Jasmine Grewal, MD – University of British Columbia