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September 06, 2019
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SCAI SHOCK to focus on diagnosis, treatment, systems issues in cardiogenic shock

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Srihari S. Naidu

The second annual SCAI SHOCK meeting, organized by the Society for Cardiovascular Angiography and Interventions, aims to offer information to help clinicians better diagnose and treat cardiogenic shock, and to promote the establishment of institutional and regional shock teams for better care, according to its program co-chair.

The meeting, which is being held in Boston, begins today with a workshop on large-bore vascular access and continues Saturday and Sunday with sessions on best practices, diagnosis, treatment, technological considerations, systems of care and more.

“We realized last year at our first meeting that the confluence of interest in the topic and the development of shock teams around the country has made this the perfect storm for an educational event that hadn’t been targeted before,” program co-chair Srihari S. Naidu, MD, FSCAI, director of the Hypertrophic Cardiomyopathy Center and Cardiac Catheterization Laboratories at Westchester Medical Center in New York and professor of medicine at New York Medical College, told Healio. “This year, the meeting has been expanded and has added a lot of content. This is the first time people will be looking at it as a comprehensive, multidisciplinary conference.”

The agenda includes discussions of shock beyond that associated with acute MI, including that associated with HF, nonischemic cardiomyopathy and peripartum cardiomyopathy, Naidu said, as well as discussions of hospital capabilities, which vary greatly.

“We want to address the fact that shock happens anywhere in the world, and every institution should be able to develop teams of experts and achieve the best types of outcomes possible, and understand which types of patients need to be transferred out to a higher level of care,” Naidu told Healio.

The agenda includes an in-depth discussion of SCAI’s shock classification scheme released in May, including “how it relates to the providers — from the ED to critical care to interventional cardiologists to heart failure and transplant specialists — taking care of the patients with shock,” Naidu said in an interview. “This will help people use it in day-to-day practice.”

The meeting will also include talks on protocols of shock management, including presentations on the different types of protocols that exist “so that people can see what is working in different places and take with them features of protocols that may be best for their particular institutions,” Naidu said.

There will also be presentations on how to create a regional system of tiered hospitals based on capabilities, and how to get buy-in for it from other hospitals and their shock teams.

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“One of the challenges of patients with shock, who have a high rate of mortality, is that they are typically not diagnosed early enough and are not typically escalated within the institution and to other institutions fast enough,” Naidu told Healio. “Sometimes, by the time diagnosis is made, the patient is too sick for transfer or has end-organ dysfunction. We are hoping that by creating a better hub-and-spoke model and promoting the concept of having regionalized centers of excellence in shock management, similar to what is seen in transplantation and other specialized areas, we can improve mortality by utilizing resources across the regional system, not just across the hospital.” – by Erik Swain

For more information:

Srihari S. Naidu, MD, FSCAI, can be reached at srihari.naidu@wmchealth.org.

Disclosure: Naidu reports no relevant financial disclosures.