Canadian Cardiovascular Congress: Andrea Schreckenbach’s Experience
Andrea Schreckenbach is a recent graduate of the Master of Physician Assistant Studies Program and a previous registered nurse at St. Boniface Hospital, working in Cardiac Sciences and Emergency. She will be starting to work as a Physician Assistant within the Cardiac Sciences program in December 2025.
The Canadian Cardiovascular Congress 2025 was a great opportunity for learning about the latest progress in the cardiovascular world of medicine. The following are the top things that I have learned from the conference regarding acute coronary syndrome and cardiovascular disease:
1) Women with psychosocial factors are at a higher risk of cardiovascular disease. These factors can include depression and anxiety, as well as women-specific factors such as increased stress in raising a family or the double-burden of responsibilities at home and work.
2) Lp (a) blood work should be ordered on all patients who are at risk for cardiovascular disease. This level only needs to be done once in a lifetime, is genetically determined, and an elevated level suggests an independent risk factor for cardiovascular disease.
3) StatSeal, which is a topical hemostatic dressing, can be used in addition to the TR band post angiogram procedure. The dressing lies directly on the skin under the TR band. Using this additional product has proven very effective in decreasing time to hemostasis post PCI, even in patients who are highly anticoagulated.
4) When cardioverting patients, healthcare providers should ensure that the ZOLL defibrillators are in the SYNC mode. When the SYNC is turned on, the provider should ensure that the SYNC marker is actually on top of the QRS complex, not the T-wave. If the machine is not recognizing this correctly, the provider should consider changing the lead or use caution when delivering the shock.
5) For patients with ACS and anemia, a transfusion threshold of <90 g/L has shown to have a reduced risk of death and MI within 30 days. However, providers should ensure that they transfuse 1 unit of PRBC at a time and consider pre-transfusion diuretics for patients at risk of fluid overload.
STEMI requires an immediate diagnosis using an ECG and timely re-perfusion with PCI. The 2019 CCS guidelines recommend for an ECG to be acquired and interpreted within 10 minutes from first medical contact. Despite this recommendation, real-world practice often falls short. A literature review of 2 databases (Medline and Embase) was conducted to investigate the strengths and limitations of several strategies that attempt to reduce door-to-electrocardiogram (D2E) time in EDs. This review concluded that while no single ideal intervention exists to improve D2E times, a combination of multiple strategies would be the most beneficial to improving D2E times. This review found 4 main steps to achieving optimal D2E times: A process to identify patients who require ECGs, having the proper infrastructure in EDs to accommodate a dedicated ECG at triage, initiating specific protocols to empower other staff members to identify patients with ACS symptoms, and maintaining ongoing education and communication with interdisciplinary teams. These strategies should be tailored to each individual ED, and times should be monitored continuously over time to maintain sustainability. Improving D2E times will help to meet the CCS guideline times of under 10 minutes and will positively affect patient care by enabling faster revascularization through PCI, reducing mortality, and preventing unnecessary complications.
Andrea Schreckenbach presenting her poster at the Canadian Cardiovascular Congress 2025
