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.

Beat SCAD launches Cardiac Rehab survey

UK SCAD patients… we need your help to improve the rehab experience for everyone!

We know that when heart patients attend and complete Cardiac Rehab programmes they have better long-term outcomes both physically and mentally.

However, we also know that some SCAD patients are not offered Cardiac Rehab or have a negative experience if, for instance, sessions are heavily geared to patients with atherosclerotic heart disease.

On the positive side, many SCAD patients have a very good experience of Cardiac Rehab.

We want to collect data on what elements of rehab make the process a positive or negative one and what could be changed to make rehab more beneficial to SCAD patients.

So we have launched a Cardiac Rehab Survey for UK SCAD patients.

Our aim with this survey is to collate feedback from SCAD patients and ensure we can provide specific guidance to Cardiac Rehab centres on what makes a good rehab experience for SCAD patients.

Regardless of how long ago or how recent your SCAD was or whether you attended a rehab programme or not, your feedback will be invaluable!

We’d love everyone to complete the whole survey, which will take around 15-20 minutes, but if you are short of time, please complete just questions 1-8, which will take about 3 minutes.

The data collected in this survey will be used to analyse cardiac rehab provision in the UK and help shape our strategy to campaign for improvements for SCAD patients. Any personal information you provide will be kept private and held securely. We will never share your details with anyone else. Click here to read our data processing and privacy policy.

Please click here to complete the survey.

The survey will close on 31 March 2020.

If you have any queries please click here to email us.

Raising awareness at Midwifery event

Raising awareness at Midwifery event

Melton & District Model Show volunteers

Beat SCAD Trustees Sarah and Karen (pictured above) had a busy day at the London Maternity and Midwifery Festival on 21 January raising awareness of pregnancy-related SCAD (P-SCAD).

The event, at Earl’s Court, attracted more than 600 maternity and midwifery staff and we handed out hundreds of leaflets, including some new ones created especially for the event. 

Delegates were very interested in P-SCAD and most had never heard of it. Some midwives told Karen and Sarah (pictured above) that they had seen SCAD patients, and a couple knew of a SCAD fatality at their Trusts. 

Current figures estimate that 10% of SCADs are pregnancy-related, and 50% of all post-partum coronary events are due to SCAD.

Sarah said “The emotional response by midwifery professionals to our P-SCAD case studies was moving and sincere. Photographs and stories stick in hearts and minds far better than dry words and statistics ever could. Beat SCAD is so grateful to our survivor community who are willing to tell their stories to raise awareness of SCAD.

We were thanked by so many midwives for making them aware. Others said they had experienced SCAD first hand in their own Trust. Many midwives say they are over-ruled by doctors when they request a troponin blood test for a woman they suspect may have had a cardiac event. This is an area that Beat SCAD will focus on going forward in our efforts to stop SCAD devastating more families.”

Click on the links below to download our new leaflets:

Pregnancy-related SCAD case studies

P-SCAD flyer telling the story of Katie Ratcliffe, who died following a SCAD

 

Study reveals majority of SCAD patients have little lasting damage to their heart

An important study to investigate the extent of heart attack (myocardial infarction) and its impact on left ventricular systolic function in SCAD patients was published on 3 January by the European Society of Cardiology European Heart Journal, the highest ranked cardiology journal globally.

Authors of the study include Dr David Adlam, who is leading the UK SCAD research, Dr Alice Wood, Research Fellow on the SCAD research project in Leicester, and Dr Abtehale Al-Hussaini, cardiology consultant who also worked on the SCAD research project.

158 SCAD patients from the UK SCAD Registry, and 59 healthy controls underwent CMR (cardiac magnetic resonance imaging) to look at their hearts and heart function.

  • The patients were 98% female with an average age at the time of SCAD of 45.8 years
  • 15 patients had a SCAD during or after pregnancy (P-SCAD)
  • A third of SCAD patients had STEMI (ST-Elevation Myocardial Infarction), which are more serious than NSTEMI (Non- ST-Elevation Myocardial Infarction)
  • 9% had had a cardiac arrest.

The study found that:

  • The left anterior descending (LAD) artery was the most commonly affected (68.6%).
  • Type 2 SCAD (a long diffuse and smooth narrowing mainly in the mid-to-distal) was the most common (72.9%).
  • 56 patients were managed with PCI (percutaneous coronary intervention – ‘stenting’), of whom 25 had complications following the procedure.
    • The most common complication was due to the haematoma (bruise) extending, and the rest were due to distal coronary or branch blockages resulting from stenting
  • 8% of patients had emergency coronary artery bypass grafting, half after an initial attempt at PCI.
  • SCAD patients in general had a very small reduction in ejection fraction (a measure of left ventricular systolic function), preserving cardiac function well in most cases.
  • A large proportion of patients (39%) do not have a detectable heart attack and a minority (6.4%) had a very large one.
  • P-SCAD was associated with larger heart attacks.

Key messages in this study include:

While a small number of SCAD survivors will be left with a larger heart scar, in most cases the lasting damage to the heart is small and in almost 40% of cases there is no detectable scar on MRI scanning after the heart has been allowed time to recover.

The paper also identifies the things associated with larger heart injuries which are:

  • ST-elevation (a feature on the ECG) at any point after presentation
  • Poor blood flow in the affected coronary artery
  • Muti-vessel SCAD
  • Hypermobility
  • There is also a signal for P-SCAD with this likely due to P-SCAD causing more extensive dissections

Dr Adlam said the paper has important implications. Firstly, the fact that 40% of cases have no detectable scar suggests that for a significant number of SCAD survivors the requirement for medications usually given after heart attacks leading to heart damage (particularly the ACE-inhibitor (-pril) and ARB (-sartan) group may be less strong (unless these medications are needed for other reasons such as high blood pressure).

Secondly, while this study confirms previous findings of high complication rates with coronary intervention (including stenting), it also identifies the key features which determine heart injury after SCAD. Knowing these features is helpful as it may be that these are features that cardiologists can use to identify SCAD patients at higher risk and in whom coronary intervention is still the best strategy despite the inherent risks.

It needs to be noted that this is observational data not a clinical trial, but it is an important step forward in our understanding of the impact of SCAD on the heart and what factors cause larger heart injuries in SCAD.

Dr Adlam said: “We are hugely grateful to the SCAD survivors, healthy volunteers and heart attack survivors who gave their time to allow this research to be carried out. We are also grateful to our funders and particularly Beat SCAD for their support, without which we would not have been able to continue our research.”

Chair of Beat SCAD, Rebecca Breslin said: “This study is an important step forward in our understanding of SCAD. The fact that the majority of SCAD patients have no or small heart attacks and preserved ejection fractions is very positive. This, and the identification of factors that are more likely to lead to larger heart attacks, including multivessel SCAD hypermobility features, will help health professionals in their treatment and management of SCAD patients.”

Click here to read the complete study.

 

 

 

SCAD survivor completes 12th 10K to raise money for Beat SCAD

SCAD survivor completes 12th 10K to raise money for Beat SCAD

Diana Walker was 49 in November 2016 when she had a heart attack caused by SCAD. She had none of the usual cardiac risk factors – no furred arteries, high blood pressure or cholesterol.

At the beginning of the year, Diana pledged to run a 10K every month in 2019 to raise money for Beat SCAD and the BHF. She wasn’t a runner before her SCAD but in April 2017 she did a zero to 5K nine-week challenge run by the Acre Street runners – and nine weeks later ran her very first 5K.

This year she did the Heaton Park 10K in January, Valentine’s Day 10K in Sheffield, Bradford 10K in March, the Sheffield neon night run and Kirklees 10K. Her challenge was not without its hiccups. At the Lindley 10K she got a groin strain half way through but still managed to hobble to the finish line. This put her out of action for a few weeks but she returned to run her seventh 10K of the year in Tinsley.

Her eleventh 10K was Rother Valley in November. Diana said: “I’m sure it’s nice in Summer but today was very very muddy and pouring. Drenched and cold but we made it round. Nice medal though!”

She added: “That’s the eleventh 10K in the bag. Due to injury earlier in the year I have had to catch up and that was the third 10K in four weeks, which is too much for someone who doesn’t find running easy at all. The clues in the name ‘Walker’!”

Last Sunday she ran her final 10K of the year at Elsecar in South Yorkshire.

Diana (pictured top left with her running buddies, sisters Tracey Cable and Julie Lockwood), has raised almost £1500 including Gift Aid, which will be split between Beat SCAD and the BHF. A massive thanks to her and all her supporters for this fantastic fundraising effort – not to mention the brilliant achievement by Diana!