Table 3.

Suggested Components of a SCAD “Center of Excellence”

Clinician champion	•Serves as a central source of local expertise in SCAD •Develops pathways to promote standardized care for the patient with SCAD in both the inpatient and outpatient settings •Responsible for the education of local colleagues in the care of patients with SCAD •Identifies local noncardiology specialists with interest and knowledge in SCAD to whom patients may be referred •Provides opportunities for patients to connect with patient advocacy groups and educational opportunities •Provides opportunities for patients to participate in research •Dissemination of education to broader audience of clinicians, eg, at highly attended medical conferences
Specialist care	•Adequate clinical volumes to maintain proficiency in the care of patients with SCAD • Ability to refer patients to specialists with interest and knowledge of SCAD, which may include vascular medicine ○ Vascular surgery ○ Interventional radiology ○ Interventional cardiology ○ Cardiothoracic surgery ○ Stroke neurology ○ Headache neurology ○ Sports cardiology ○ Psychiatry/psychology ○ Medical genetics ○ Maternal fetal medicine/high-risk obstetrics ○ Cardiac rehabilitation
Diagnostic imaging	•Availability of accessible cardiac imaging including coronary angiography, coronary computed tomography angiography, cardiac magnetic resonance, vascular ultrasound, and vascular angiography (magnetic resonance angiography or computed tomography angiography). •Imaging protocols that have been optimized for women of childbearing age (eg, low contrast load, low radiation exposure) •Imaging protocols with specific considerations for pregnant and lactating individuals
Research	• Ability to participate in multicenter research including registries ○ Biorepositories ○ Clinical trials