New guideline can help PCPs manage aortic disease

An updated guideline from the American College of Cardiology and the American Heart Association on diagnosing and managing aortic disease emphasizes the importance of a multidisciplinary care team.

Primary care physicians often encounter aortic disease in practice, “and this new guideline can help such frontline providers feel comfortable both evaluating and managing these patients,” Eric M. Isselbacher, MD, MSc, director of the Healthcare Transformation Lab and co-director of the Thoracic Aortic Center at Massachusetts General Hospital, and chair of the guideline writing committee, told Healio.

In most cases, aortic aneurysms are first identified by primary care providers, typically when they order diagnostic imaging studies for another reason, like an echocardiogram or a chest CT, Isselbacher said.

“The good news is that most modest-sized aneurysms can be managed by PCPs, so providers should be familiar with the various causes of aortic aneurysms, when to screen family members, optimal medical therapy and appropriate surveillance imaging,” he said. “This new guideline provides recommendations on each of these topics in a convenient modular fashion, making it easy to find the right information to guide the management of any given patient.”

The guideline states that patients who need aortic intervention have better outcomes when the surgery is performed by someone experienced and working in a multidisciplinary aortic team. Specifically, it recommends “a specialized hospital team with ... expertise in the evaluation and management of aortic disease, in which care is delivered in a comprehensive, multidisciplinary manner.”

Isselbacher said the guideline also “recognizes the value of multidisciplinary aortic teams in the management of patients with complex aortic disease,” which “may shape a PCP’s decision about where to refer a patient when aortic repair is being considered.”

“Finally, the guideline emphasizes the important role of shared decision-making in the care of patients with aortic disease, and PCPs are encouraged to participate in that shared decision-making process,” he said.

In closing, Isselbacher stressed the importance of individualized health care.

“The management of each patient with aortic disease should really be individualized, so it’s worth rechecking the guideline to review the recommendations for each patient’s particular condition and circumstances,” Isselbacher said.

For more information about the new guideline, read Healio’s full coverage here.

References:

ACC, AHA issue aortic disease guideline. https://www.eurekalert.org/news-releases/969397. Published Nov. 2, 2022. Accessed Nov. 22, 2022.

Isselbacher EM, at al. J Am Coll Cardiol. 2022;doi:10.1016/j.jacc.2022.08.004.