245 - CARDIO-RHEUMATOLOGY - HEARTS ON FIRE

Workshop Description: Patients with Autoimmune Rheumatic Disease (ARD) can present with a broad spectrum of cardiovascular manifestations including premature atherosclerotic cardiovascular disease (ASCVD). The mechanism for development of ASCVD in presence of systemic inflammatory disease has been linked not only to a higher prevalence of traditional cardiovascular risk factors, but importantly to chronic inflammation contributing to impaired endothelial and microvascular function, leading to early. Additionally, patients with systemic inflammatory disorders are at high risk for a wide range of other cardiac and vascular problems, including myocarditis, ischemic as well as non-ischemic cardiomyopathy, pericarditis, pericardial effusions, valvulitis, cardiac arrhythmias, pulmonary hypertension, and vasculitis. Many of the medications used in treatment of ARDs can alter this risk and can have both cardio-protective and at times, cardio-toxic effects. We aim to address three areas within the field of cardio-rheumatology in this workshop: ASCVD risk stratification, Anti-Malarial Induced Cardiomyopathy, and Pericarditis associated with ARDs.

Presentation 1: ASCVD risk stratification in patients with autoimmune rheumatic disease
Cardiovascular risk assessment in the presence of chronic systemic inflammatory disease is challenging. The commonly used traditional cardiovascular risk calculators usually underestimate and sometimes overestimate CV risk in patients with ARDs. Traditional CV risk factors can vary markedly over time in patients with ARD, partly due to variable disease activity and treatment-related factors.
Cumulative exposure over time to risk factors such as elevated cholesterol and hypertension are better able to quantify ASCVD risk, yet these dynamic risk factors are difficult to capture in a single-point-in-time model. This presentation will review current knowledge about ASCVD risk stratification in this population, review related societal guidelines, and provide a practical approach to more accurate ASCVD risk stratification in this population.

Presentation 2: Anti-malarial Induced Cardiomyopathy (AMIC)
Antimalarial drugs chloroquine and hydroxychloroquine, commonly used in treatment of ARDs such as Rheumatoid Arthritis and Systemic Lupus Erythematous can have both important cardioprotective as well as rare, but potentially life-threatening cardiotoxic side effects such as HF and arrhythmias in patients who develop cardiomyopathy with long-term use. This presentation will provide an overview of clinical presentations, diagnostic approach and management of patients with AMIC.

Presentation 3: Complex Chest Pain in Patients with ARD
Patients with underlying ARD can have chest pain as part of their clinical picture. Teasing out the etiology of the pain can be challenging. Using a case-based format, we will review diagnostic approach to the patients with ARD with 'complex chest pain'.

Interactive and Engagement Activities Description: Live Polling
Q&A period using ARS
Panel discussions