ASNC2020’s Smart Start: 'Cases with the Aces' from Cedars-Sinai

"Now we'll begin the first session of ASNC2020 – Cases with the Aces, from an outstanding center, Cedars-Sinai, and chaired by a pioneer and a giant in our field, Dan Berman, with his team, including John Friedman and Sean Hayes."  

With those words, ASNC2020 Program Chair Terrence Ruddy, MD, MASNC, launched the first of ASNC2020's more than 20 live virtual sessions to be delivered over the next four weeks. 
And what a way to start! The Cedars-Sinai team walked attendees through 17 cases, showcasing various imaging modalities as well as how experts think when interpreting both the straightforward and the complex. 

The session's cases included seemingly mild defects that turned out to be severe disease; lesions that are "hard to see on CTCA"; hypertrophic cardiomyopathy; TAVR referrals; ATTR cardiac amyloidosis; extensive coronary calcification; a demonstration of the risks of misunderstanding, or incorrectly applying, the ISCHEMIA trial results; and more.    

Logging in from all around the world, attendees watched as Dan Berman, MD, MASNC, John D. Friedman, MD, and Sean W. Hayes, MD, used cases to demonstrate – 
  • How to salvage studies using motion correction or prone imaging;
  • When to review wall-motion images in gray scale without contours; 
  • How myocardial flow data can be used to predict anatomy;
  • When to suspect misregistration and how to reprocess for better alignment;
  • How adding calcium scoring can reduce uncertainty in some scenarios; 
  • How to fine-tune images; 
  • Why they always start with rest imaging with ER patients; 
  • And much more!  
The session also highlighted the advantages of different imaging modalities depending on the context; seminal studies; and teaching points. 

"For learners, this session was a master class on putting the whole study together, paying attention to subtle findings and case details," said ASNC President Sharmila Dorbala, MD, MPH, FASNC. "There is no substitute for watching how experts sift through images, ask questions, seek out more data, and fill in the blanks to inform disease management. I look forward to next week's Cases with the Aces session with the team from the Ottawa Heart Institute."