a A surge in cardiovascular disease cases is straining the Queen Elizabeth Hospital’s medical resources, the hospital’s top cardiologist has said.
Head of Cardiovascular Services, Dr Dawn Scantlebury, reports that heart attacks, once rare, are now reported at least once every day, with changes in the lifestyles and diets of Barbadians contributing to a worsening epidemic of chronic disease.
“In the ’70s, when cardiology was still in its infancy in Barbados and cardiology units were first set up, the main cardiovascular disease we were seeing was rheumatic heart disease,” Dr Scantlebury said. QEH Pulse Radio show. “It was associated with infections, and it was fairly common, but not that common. We didn’t have a lot of burden. Heart attacks were rare, and they were in visitors.”
“What we’re seeing now is more than one heart attack a day. We’re seeing patients dying suddenly at home, or coming into the hospital with sudden chest pains and things like that. Coronary artery disease, something that was unheard of in the ’70s and ’80s, has become very common. Part of that has to do with our changing lifestyles.”
QEH currently treats a wide range of cardiovascular conditions, including coronary artery disease, heart failure and arrhythmias such as atrial fibrillation and ventricular tachycardia. Sudden cardiac death is also a major concern.
Dr Scantlebury, who is also first vice-president of the Barbados Heart and Stroke Foundation, pointed to a worrying trend: “When people think of cardiovascular disease and heart attacks, many think it’s an older person’s problem so it’s not their problem, but that’s not the case. We are certainly seeing patients from early childhood onwards, but the age at which heart disease, heart attacks and heart failure develop is decreasing and it’s affecting men, women, young mothers, everyone.”
The rise in cardiovascular disease is putting a huge strain on the resources of the island’s only public hospital. Director of Medical Services Tony Harris noted a stark difference from the past, saying, “When I was in the medical intensive care unit in 1971, heart attacks were relatively rare, maybe once a week. But today, the unit is dealing with more than one heart attack a day.”
Harris went on to explain the wider impact on the healthcare system: “We certainly see an all-time high demand for intensive care units in hospitals to cater for these conditions. And this is just cardiac disease, and that doesn’t take into account strokes, which are probably more prevalent in our population than heart attacks and so on. So that’s something that we have to address. And then of course the other thing is NCDs, high blood pressure, kidney failure due to diabetes, which are also increasing at staggering rates.”
Both Dr. Scantlebury and Dr. Harris emphasized that managing cardiovascular health requires lifestyle changes and patient education. “We have to do a lot of education, and it’s a daily thing,” Dr. Scantlebury said. “With every patient that I see, there’s some kind of discussion about physical activity, about what they need to eat to prevent their condition from worsening.”
The foundation of my business is still that lifestyle, so I often tell my patients that when it comes to healthy eating, they need to get back to the earth and eat more plant-based foods. [foods]You all have a great deal to contribute to us when it comes to managing your cholesterol, diabetes and high blood pressure, and by taking your health back into your own hands and taking control, you can actually contribute to reducing your medication burden – the number of pills you take.”
The QEH’s cardiology department offers a wide range of services, from non-invasive tests to invasive procedures such as angioplasty and stent placement, but the department faces significant staffing and resource challenges, he added.
Harris said efforts are underway to address these challenges: “In 2018, we began to assess the projected load and demand for cardiac services and successfully advocated for increased staffing. We are working to increase staffing levels in the medical, nursing and technical areas to better meet the growing demand for cardiac care.”
Dr. Scantlebury emphasized the need for continued innovation and education: “Effectively managing the growing burden of cardiovascular disease requires continued innovation and education for both patients and healthcare providers. Our goal is to provide the best possible care and adapt to the evolving landscape of heart disease.”
