Myles Textbook for Midwives includes SCAD for the first time

Myles Textbook for Midwives includes SCAD for the first time

We are very excited to announce that, for the first time ever, information about SCAD has been included in a textbook for midwives, distributed in more than 75 countries. This will increase awareness of SCAD among student midwives and hopefully lead to earlier diagnosis and treatment for women who have a SCAD during or after pregnancy.

Myles Textbaook for Midwives coverBeat SCAD was approached two years ago by Elsevier, the publishers of the Myles Textbook for Midwives. We were asked to contribute a section on SCAD for the 17th edition, which has just been published. Current figures suggest that around 10% of SCAD patients are pregnant or post-partum women and they tend to have worse outcomes than other SCAD patients.

Dr David Adlam

Dr David Adlam, lead UK SCAD researcher and Consultant Cardiologist at Glenfield Hospital, Leicester, said: “The critical first step in cases of spontaneous coronary artery dissection is ensuring a rapid accurate diagnosis. This ensures patients are in a place of safety where their condition can be looked after by experts. Educating healthcare professionals to be aware and look out for SCAD is vital. This project complements a huge effort by Beat SCAD and the UK SCAD clinical team to disseminate knowledge about SCAD to our Midwifery colleagues, and we are sure this will reduce the numbers of patients with delayed diagnosis of pregnancy associated or post-partum SCAD.”

Neil Stewart, Editorial Director, Maternity & Midwifery Forum, added: “As medical science advances so the knowledge of more rare risks in pregnancy emerges and can be identified. So expands the range of risk factors that Midwives need to be aware of and recognise. Earlier diagnosis enables effective treatment and helps women understand future risk. This is a valuable addition to the knowledge base of midwifery and a timely inclusion into their education.”

The story started back in April 2018 when Beat SCAD Trustee Karen Rockell secured a speaking opportunity for the charity at a meeting of 40 Lead Midwife Educators in London. Trustee Sarah Coombes and fellow SCAD survivor Victoria Warnes-Elgie presented, alongside Dr Abtehale Al-Hussaini (Dr Abi), Consultant Cardiologist at Chelsea and Westminster Hospital.

Lead midwives talk

Following a discussion with Professor Jayne Marshall, co-editor of the textbook, Sarah was invited to contribute an entry about SCAD for the new edition.

We were very pleased to be involved in this project as it has enabled us to:

  • Highlight the importance of SCAD in a textbook that is widely read by student midwives globally, hopefully reducing the number of times SCAD gets missed and misdiagnosed among pregnant and recently pregnant women.
  • Highlight the fact that some clinicians are now supporting women through successful post-SCAD pregnancies using a multidisciplinary team approach based on individual risk assessment. This counters many other published articles which have tended to say that clinicians never recommend pregnancy after SCAD.
  • Include a SCAD case study featuring Nicki Owen, to show how the perception that young, fit, pregnant women showing cardiac symptoms can’t be having a cardiac event, needs to change.
  • Provide a link to the video ‘You might die if you have a baby’, which tells the stories of Victoria and another SCAD patient, Hayley, and focuses on Dr Abtehale’s work in this area.
  • Provide student midwives with links to the SCAD stories of Rachel, Robyn and Victoria.
  • Ensure the European Position Paper on SCAD was included as a resource.

Myles-Texbook-for-Midwives-SCAD-page-copyright-Elsevier

Beat SCAD would like to thank Professor Marshall for the opportunity and Victoria, Haley, Nicki, Rachel and Robyn for their contributions to this brilliant result for the SCAD community.

If you have not yet told your SCAD or P-SCAD story, please consider doing so – you never know where your story could end up being told! Click here for more information.

The section on Spontaneous Coronary Artery Dissection was published in the Myles Textbook for Midwives 17th Edition, Authors Jayne Marshall and Maureen Raynor, Page 367, Copyright Elsevier 2020. Cover and page image reproduced by kind permission. 

Beat SCAD funds Clinical Research Fellow

Beat SCAD funds Clinical Research Fellow

Thanks to all the amazing fundraising all our supporters have done, we achieved our ambitious fundraising target of £64,000 and are now funding Dr Alice Wood, Clinical Research Fellow on the UK SCAD study.

Dr Wood is focusing her work on sub-groups, such as men and recurrent SCADs and this funding will enable her to continue that research for another year.

Getting funding for research is challenging, so we are very pleased this study is able to continue for another year and grateful to all our dedicated fundraisers for their fantastic achievements.

Christmas card competition 2020

Christmas card competition 2020

 Yes, we know it’s July and Christmas is a long way off, but we have some exciting news. Your photo, drawing or digital design could be printed on a Beat SCAD Christmas card!

We ran a very successful competition in 2018 where we received some beautiful designs, four of which were printed and sold in our shop.

Christmas card competition winners

This year, we’d like to expand our Christmas card range again, and would love to include designs from the SCAD community, family, friends and supporters.

Your designs can be a photo, hand drawn or computer generated and can be in colour or black and white and must be in two dimensions. You can choose one of three sizes – A6 landscape, A6 portrait or Square (click here to see templates).

We’d like the designs to be festive and you are welcome to include references to spontaneous coronary artery dissection and/or hearts.

We have two categories: children up to the age of 14, and adults and children over 15.

Up to four winning designs will be chosen and printed on Christmas cards sold by Beat SCAD to raise money to continue raising awareness, supporting SCAD patients, families and friends and furthering research into this condition.

The winners of the Children’s Competition will receive a £30 Amazon voucher plus two free packs of cards printed with their design.

The winners of the Over-15s and Adults’ Competition, in addition to seeing their design on the front of the Christmas cards, will receive one item of their choice of Beat SCAD clothing and two free packs of cards printed with their design.

All proceeds from the sale of the Christmas cards go to Beat SCAD.

Closing date: 31 August 2020

Click on the links below for more information and the entry form:

Competition details and terms and conditions 

Card templates  

Entry form (pdf) 

Entry form (Word) 

So what are you waiting for? Get creating!

Raising awareness in Wales

Raising awareness in Wales

Earlier this year, Beat SCAD Trustee, Harriet Mulvaney, met with the BHF in Wales to discuss how Beat SCAD could work with them to help raise the profile of SCAD patients and their treatment in Wales.

Elections for the Welsh Parliament, the ‘Senedd’,  will be held in 2021 and ahead of this, BHF Cymru are currently engaged in activity to build their long-term strategy to influence politicians.

One of the key aspects of this work is bringing attention to the gender gap that exists when treating heart patients. Research has shown that women are treated differently, and often with poorer outcomes.

Harriet (right) was asked by BHF Cymru’s Policy and Communications teams to help contribute to an article on this topic, to appear in an influential publication by the think tank, the Institute of Welsh Affairs. This article, ‘Closing the gender gap: treatment of heart patients in Wales’, appeared in the Spring/Summer 2020 edition, #Rethinking Wales. Click here to read it and scroll to page 40.

Harriet is continuing to work BHF Cymru on a number of smaller projects, including a social media campaign to encourage heart patients in Wales to access the BHF resources available to them during COVID-19 lockdown.

Harriet hopes that building stronger ties with BHF Cymru will lead to a long-term relationship that can help Beat SCAD continue to raise awareness and support patients living in Wales.

Virtual fundraiser in memory of Katie Ratcliffe

Virtual fundraiser in memory of Katie Ratcliffe

Paul Barnett, brother of Katie Ratcliffe, who died last July following a SCAD, is organising a virtual 5km or 2km walk or run in memory of Katie.

Paul says: “The runs or walks can be at any time of day on Sunday 31 May in a park, local streets or even your back garden.”

Katie was a primary school teacher for 10 years and this virtual event will raise money for Beat SCAD and Friends of Wheelock School (FOWS). 

Paul has set up a Just Giving page. Unfortunately, Just Giving doesn’t allow people to fundraise for two charities on the same page, so it has been set up with the money going to FOWS, however, after the event 50% of the funds raised will be transferred to Beat SCAD.

“We are suggesting a floral theme for the event as Katie loved flowers so hopefully we’ll see lots of flowery selfies,” says Paul.

Paul is in the process of setting up a results system and you will be able to print a race number with Katie’s picture and the charities’ logos. Everyone who prints the race number will wear the number 33, the age Katie was when she tragically passed away

Research update: male and recurrent SCADs

Research update: male and recurrent SCADs

The UK SCAD research project is currently focusing on a detailed sub-study looking at men with SCAD, and people with recurrent SCAD. Dr Alice Wood, Research Fellow (pictured above), started recruiting patients in September 2018.

Why men?

Dr Alice Wood said: “I chose to study men with SCAD because this is a group that really hasn’t been looked at in the past. Decades ago, SCAD was thought to be a condition that only affected women, primarily in pregnancy. We therefore hope to clarify why SCAD happens in men who of course are not exposed to the hormonal fluctuations of the menstrual cycle, pregnancy, and the menopause. In addition, it is clear that hormonal changes are not the only risk factors for SCAD in women, and we hope that studying men will provide some insight into other factors, which will also be informative for our female patients.”

Why recurrent SCADs?

There were two reasons for looking at patients who have had more than one SCAD. “Firstly, we wonder whether these are people with a more marked tendency to SCAD, meaning that with small sample numbers we will be more likely to identify differences and thus find out more about why SCAD happens,” explained Dr Wood.

“Secondly, it is clearly very important to patients to understand recurrence risk, and so if we can identify particular factors that predispose to recurrence, this will be of great clinical value.”

What does the study involve?

Dr Wood has recruited both SCAD patients and healthy volunteers, who act as ‘controls’. She is doing a number of tests in both groups. These are:

Brachial artery flow mediated dilatation – this is a test that looks at the reactivity of the artery in the arm. “The reason for doing this test is that we wonder whether the coronary arteries in SCAD may be more reactive, more prone to spasm or constriction for example, and whether this might be something that we can demonstrate in the arm arteries,” said Dr Wood.

Exercise testing – the study is are looking at this for a number of reasons. “On pragmatic clinical grounds, many of our patients are keen to get back to sport and we want to confirm our belief that this is safe, and that SCAD patients do not have particular issues with exercise,” Dr Wood explained.

“We know that a small proportion of SCAD patients suffer their event during or after exercise, and we want to look at whether there may be reasons for this such as a more dramatic blood pressure response to exercise in these patients,” she added.

“We are also interested in studying the autonomic (involuntary) nervous system, which controls many aspects of bodily function including responses to stress, and one way of studying this is by looking at heart rate recovery, the rate at which the heart rate returns to baseline after its rise with exercise.”

Cardiac MRI with pharmacological and psychological stress – cardiac MRI shows a number of things. It allows the researchers to look at the cardiac structure and function, and the size of any scar after SCAD. In this particular study Dr Wood is also looking at responses to pharmacological stress, to see whether there is any difference in perfusion (the passage of fluid through the circulatory system) in patients with SCAD.

Dr Wood said “We know there is not likely to be a difference in perfusion in the major arteries as most patients with SCAD have angiographically normal coronary arteries if they have further imaging, however it is possible that there are differences in the microvessels (too small to see on angiography) which may explain phenomena such as post SCAD chest pain.”

She added: “I am also looking at psychological stress as we know that a proportion of SCAD cases happen after psychological stress, and that some SCAD survivors have chest pain when under emotional stress. I am interested to see both whether SCAD survivors have more marked responses to psychological stress (in terms of blood pressure and heart rate) and also whether this affects myocardial perfusion.”

24-hour ECG – this is to look at heart rate variability which is a marker of autonomic (involuntary) function. As above the researchers are interested in autonomic function because it controls things like blood pressure and heart rate response to stress, which may be different in SCAD patients.

Dr Wood’s plan is to study 30 male patients and 30 female recurrence patients, with 30 matched controls for each group. So far she has recruited all 30 male SCAD survivors, 18 male healthy controls, 17 women with recurrent SCAD, and 10 female healthy controls. There are also a good number of participants booked in for visits over the next few weeks.

Dr Wood added “I am very grateful to Beat SCAD for their support (financial and otherwise) for this work.”

If you are registered for the research and have had a recurrent SCAD, please email the research team rather than register again. If you have not already registered for the research (whether or not you fall into these two patient groups) please click here.

Dr Wood’s work is part-funded by generous donations and fundraising by Beat SCAD supporters.