For patients in central and north Island, there is no catheterization laboratory where doctors can perform procedures common since the early 2000s
A critical lack of cardiac care in the central and north Island means heart attack patients in Nanaimo are likely to get blood thinners and clot busters instead of highly recommended interventions available in Victoria, says a Nanaimo doctor.
The result is more avoidable deaths and poorer quality life and outcomes, said Dr. David Coupland, a radiologist and president of Nanaimo Regional General Hospital medical staff, who will speak to the issue at a press conference in Nanaimo today.
Nanaimo Regional General Hospital is serving a rapidly growing and aging population. It’s among largest regions in Canada without a cardiology service and a cardiac catheterization lab where doctors can perform life-saving, non-surgical interventions, Coupland said.
“Basically, anyone living north of Duncan … is at a greater risk when a heart attack occurs,” Coupland said in an interview. “We are offering central and north Island patients care that is outdated and not to current standards for a population of our size and burden of cardiac disease.”
Generally speaking, Nanaimo’s hospital can offer big heart attack patients what’s called thrombolysis, medication given intravenously or via a catheter to dissolve clots in arteries — the main cause of heart attacks and ischemic strokes. By contrast, in a catheterization laboratory, commonly called a cath lab, doctors can perform updated procedures — common since the early 2000s — that include opening up blocked arteries and inserting a stent, he said.
Given the rapidly growing central Island has the oldest population in Canada, with the 55 and older demographic projected to grow, it also has a greater burden of cardiac disease in every area of cardiology than the south Island, said Coupland.
Heart attacks, heart failure, chest pain due to heart disease, hardening of the arteries and irregular heartbeat are above the provincial average in the central and northern regions, he said.
“Yet, we have one cardiologist at NRGH with a second one coming Aug. 14. We have few cardiac services and no cardiac cath labs versus the south Island with 22 cardiologists, including cardiac services such as electrodiagnostics, two cardiac cath labs, and cardiac surgery,” said Coupland.
Royal Jubilee is the Island’s referral centre for cardiac care.
“I mean, the inequities could not be more obvious. We have more people with heart disease north of the Malahat with very little,” said Coupland.
A cath lab at Nanaimo’s hospital would serve people beyond Nanaimo in communities such as Comox, Campbell River, Ladysmith, Port Alberni, Tahsis. In the medical community, it is well accepted that a person having a serious heart attack should have access to a catheterization lab within 90 minutes, he said.
“These people could not get to Victoria within 90 minutes if they have a big heart attack, so they get substandard care — that’s the bottom line,” said Coupland.
Nanaimo Mayor Leonard Krog, in an interview, said that, for its size, the Nanaimo region is the most underserved — “I can say this without exaggeration” — in the country in terms of not having access to a catherization lab.
“What that means is that if you have a heart attack in Nanaimo, or near Nanaimo, and you can’t get to the cath lab in Victoria … obviously then you have a much higher risk of not surviving a heart attack,” said Krog.
“And even if you do survive the heart attack, if you’d have had access with cath lab, you would also probably have a far better quality of life and be less of a user of the healthcare system in the following years, he said.
The mayor concedes “this issue will cause stress for citizens,” but if such advocacy translates into Nanaimo’s hospital getting needed cardiac services “then that’s the price we have to pay.”
Krog will join Coupland in a press conference at 11 a.m. today at the Millstone Medical Centre, 203 – 1629 Dufferin Cres., calling on the province for improved cardiac care at Nanaimo Regional General Hospital.
They will speak alongside hospital cardiology head Hesam Keshmiri, nephrology head Alison Croome, Regional Hospital District board chair Ian Thorpe and others.
Snuneymuxw Chief Michael Wyse, who is a heart patient, will also be urging the province to act swiftly to bring more timely life-saving interventions to central and north communities. About eighty per cent of the Island’s First Nations communities live north of the Malahat, many in rural and remote regions. In Canada, cardiovascular disease affects 7.1 per cent of Indigenous adults, compared with 5 per cent of non-indigenous Canadians.
“I cannot stress enough the urgency of addressing the critical lack of cardiac care in central and north Island,” said Wyse in a news release. “Lives are at risk due to the absence of a cath lab.”
