Obstructive CAD is just one etiology of ischemia. If no obstructive disease, consider coronary microvascular dysfunction #CMD. So what is best imaging modality for CMD? @VTaqMD #SCCT2021 ImageImageImageImage
How to evaluate for #CMD? A multidimensional cardiac stress PET test can evaluation for perfusion, function, and coronary blood flow. @VTaqMD #SCCT2021 ImageImageImage
Distribution of risk by coronary flow reserve #CFR. Even in absence of inducible ischemia or obstructive lesions, impaired CFR is associated with increased CVD risk. When severely impaired, CFR more prognostically significant in women. @VTaqMD #SCCT2021 ImageImageImageImage
#CMD is prevalent. #CFR <2 is prognostic of risk. Patients with low CFR plus elevated troponin, or low CFR with elevated E/e’, had even worse prognosis. @VTaqMD #SCCT2021 ImageImageImageImage
CMD is associated with worse prognosis in obesity than BMI alone. PET and CCT offer complementary information about risk. CMD also interactions with macrovascular disease. @VTaqMD #SCCT2021 ImageImageImage
Would a diagnosis of #CAD, not just #CMD, influence management? In setting of known CAD, would a diagnosis of CMD influence management? And top 3 takeaway points about CMD by @VTaqMD #SCCT2021 ImageImageImage

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More from @ErinMichos

17 Jul
Now up, growing your program through modern media by @purviparwani. In current era, #SoMe is a powerful tool for growing your program. #SCCT2021 ImageImageImageImage
Strategies for growing your growing your advanced imaging program through modern media. Great talk by @purviparwani #SCCT2021 ImageImageImageImage
5 tips for growing #CardiacCT program @purviparwani #SCCT2021. Tip 1: Make imaging relevant to clinical problem. Tip 2: Imaging content on #SoMe. Tip 3: 80/20 rule of original content/promotion. Tip 4: 360 degree Marketing ImageImageImageImage
Read 4 tweets
17 Jul
#YesCCT : Clinical reporting & understanding finance by @docjuanb at #SCCT2021 . There are reimbursement challenges . #Cardiac CT is in the wrong Ambulatory Payment Classification (APC). Bill also must be supported by clinical symptom & diagnostic ICD10 codes. Not a “rule out”. ImageImageImageImage
Reimbursement tracks with the CPT used so use the right CPT code and make sure language in report supports that code. All CTA assumes 3D, thus need to mention 3D in report. Have your reporting align with @Heart_SCCT guidelines. @docjuanb at #SCCT2021 ImageImageImage
Unfortunately #cardiacCT often lumped into CT not cardiac. Hospitals should update cost charges to accurately reflect true cost of work, align w/ other cardiac testing. With costs underreported, CMS bases APC & reimbursement on these historically lower costs @docjuanb #SCCT2021 ImageImageImage
Read 4 tweets
17 Jul
Lessons learned in training your #yesCCT team by @appropriateuse #SCCT2021 : Step 1: Learn the current set-up. ImageImageImageImage
Lessons learned in training your #yesCCT team by @appropriateuse #SCCT2021 : Step 2: Expand the service. Step 3: Educating the team. ImageImageImageImage
Lessons learned in training your #yesCCT team by @appropriateuse #SCCT2021 : Step 4: Quality Assurance; Step 5: feedback; step 6: Management ImageImageImageImage
Read 4 tweets
16 Jul
Patients with #MINOCA were more likely to be women and have fewer traditional CV risk factors. Heterogenous pathophysiology – etiology is of great importance to guide treatment. Inge van den Hoogen #SCCT2021 ImageImageImageImage
#MINOCA diagnosis. Overt non-cardiac disorders need to be excluded. Also need to rule out missed obstruction and non-ischemic causes of myocardial injury. Then after MINOCA diagnosed, need to workup etiology. Inge van den Hoogen #SCCT2021 ImageImageImageImage
Plaque disruption and plaque erosion cause some cases of #MINOCA – diagnose with OCT or IVUS, but not CCTA. Inge van den Hoogen #SCCT2021 ImageImageImage
Read 5 tweets
16 Jul
Women are not smaller men! #Atherosclerosis genesis, progression & sequelae different in women. Plaque erosion causing ACS more common in women. Women have unique #SDOH, are undertreated with #cvPrev therapies & #GDMT, leads to worsening outcomes in women. @lesleejshaw #SCCT2021 ImageImageImage
Women’s CVD risk can be underestimated. Female specific risk enhancers help. #CAC if risk uncertain. Women have lower #CAC prevalence than men but prevalence increases after menopause. CAC when present confers greater risk of incident CVD in women than men. @lesleejshaw #SCCT2021 ImageImageImage
Prevalence of non-obstructive #CAD is higher in women but is prognostic of risk. @lesleejshaw #SCCT2021 ImageImageImage
Read 6 tweets
22 Oct 20
Dr @jctardif_mhi discusses #COLCOT and updated meta-analysis of #colchicine in CAD. #CCCongress #CCC2020 @SCC_CCS
Colchicine in CAD conclusions by @jctardif_mhi and I look forward to the results of COLCOT-T2d of colchicine in #T2D without CAD. #CCCongress
Read 5 tweets

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