190 - CNCT SPOTLIGHT: NEW ALGORITHMS FOR CHEST PAIN DIAGNOSIS - THE ROLE OF CARDIAC CT & NUCLEAR IMAGING

Saturday, October 29, 2022

11:00 AM – 12:00 PM EDT

Location: Room 214

Target Audience: General: All cardiovascular (clinical and research) health professionals, Nuclear and CT Imaging specialist

Co-Chair(s)

Mustapha Kazmi

Clinical Assistant Professor
University of Calgary
University of Calgary
Calgary, Alberta, Canada
VT

Vikas Tandon

Cardiologist
CNCT
Hamilton, Ontario, Canada

Planning Committee Member(s)

Daisy Dulay, MD FRCPC

Director of Patient Safety and Quality
Island Health
UBC
VICTORIA, British Columbia, Canada
PJ

Phil Joseph

Cardiologist
Hamilton, Ontario, Canada
IM

Ilias Mylonas

Presenter
Calgary, Alberta, Canada
AS

Alexei Savtchenko

Cardiology Fellow
Calgary, Alberta, Canada

Disclosure(s):

Mustapha Kazmi: No financial relationships to disclose

Vikas Tandon: I do not have any relevant financial / non-financial relationships with any proprietary interests.

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

Phil Joseph: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Alexei Savtchenko: I do not have any relevant financial / non-financial relationships with any proprietary interests.

Learning Objectives:

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

identify strengths and limitations of Cardiac CT and Nuclear perfusion imaging for the diagnosis of CAD;
identify clinical decision tools that can be used to help minimize testing when appropriate; and
identify emerging techniques (i.e. CT-FFR, combined anatomical/functional testing) that may be clinically used in the near future.

Over the past few decades new imaging modalities like cardiac CT, stress CMR and cardiac PET have emerged as well validated tools for the clinical evaluation and diagnosis of chest pain. Like the more established techniques of exercise treadmill testing, SPECT and stress echocardiography these new modalities have their own strengths and limitations. With increasing options the clinician is often left with the dilemma of which test to choose to most effectively diagnose or exclude CAD.

In 2021, the American Heart Association and American College of Cardiology jointly issued substantially updated guidelines on the evaluation and diagnosis of chest pain. Within this, large changes were made in the approach to selecting the most appropriate non-invasive test for evaluating CAD. With choosing the right test for the right patient at the right time now a major priority in Canadian healthcare, these guidelines are potentially useful to help guide clinicians to the most appropriate selection of a non-invasive test in an effort to minimize unnecessary testing. However, it is also necessary to understand how these guidelines are generalizable to Canadian practice, and whether there is strong justification to choose one test over another.

In this workshop we aim to provide attendees a review of this newly published algorithm with a Canadian context in mind. The role of cardiac CT and Nuclear perfusion imaging will specifically be examined, highlighting both strengths and limitations of these modalities in the evaluation of chest pain. Emerging CT and nuclear imaging techniques will also be discussed.

Presentations:

11:00 AM – 11:05 AM EDT

WELCOME AND INTRODUCTIONS
11:05 AM – 11:15 AM EDT

UPDATE ON CHEST PAIN EVALUATION
Presenter: Annie Y. Chou – St. Paul's Hospital / Providence Health Care
11:15 AM – 11:30 AM EDT

ROLE OF CARDIAC CT
Presenter: Koen Nieman – Stanford University
11:30 AM – 11:45 AM EDT

ROLE OF NUCLEAR IMAGING
Presenter: Gary Small, MB, BCh, BSc, PhD, MRCP – University of Ottawa Heart Institute
11:45 AM – 12:00 PM EDT

Q&A