Cardiologist sees lack of service for Island heart failure patients

Report finds system ‘riddled with gaps,’ with low access to specialized clinics

Vancouver Island is under-serviced when it comes to the number of heart function clinics and the resources to staff them, says Vancouver Island’s only heart failure specialist.

“We are under-serviced when you look the percentage of patients that need heart failure support — we are absolutely under-serviced,” said cardiologist Elizabeth Swiggum, the medical director of the heart function clinic and cardiac rehabilitation program at Victoria’s Royal Jubilee Hospital.

There are three heart function clinics on Vancouver Island — at Royal Jubilee Hospital, and in Nanaimo and Campbell River — and 22 in B.C. The clinics help heart failure patients, family and caregivers to manage symptoms and medications and support behaviour changes such as diet and increased physical activity.

By comparison, Quebec has 47 such clinics, according to the Heart and Stroke Foundation’s 2016 report on the health of Canadians, called The Burden of Heart Failure.

Heart failure means that the heart muscle is not pumping blood as well as it should because of damage from heart disease such as a heart attack. It is a chronic condition that gets worse over time, and can be managed and treated but not cured. Half of heart failure patients will die within five years, and most will die within 10 years. It results in direct costs of more than $2.8 billion each year in Canada. And heart failure is increasing. There are more than 19,000 people living with heart failure on Vancouver Island, Swiggum said. B.C. Health Ministry data from 2013 show the number of patients on the Island with heart failure has increased 16 per cent since 2009 and 39 per cent since 2003.

The report says Canada is failing heart failure patients. Experts and patients across Canada surveyed for the report say the system is “riddled with gaps.”

Although specialized heart failure clinics are good, the report says, “access to these specialized services is low.”

Referred to has heart function, cardiac function, or heart failure clinics, the facilities also allow patients to receive regular followup from cardiologists, internists, nurses, exercise specialists, psychologists, psychiatrists, social workers and general practitioners. The goal is to reduce symptoms of heart failure, improve heart function and reduce hospitalization and death.

“According to the heart failure experts surveyed, these clinics provide excellent care, but there are far too few to serve the broad — and growing — heart failure problem,” the report says.

It also says there are too few heart failure specialists, that not enough patients are being seen by the right specialists, and that there is a lack of specialized training for family doctors to deal with complex cases. Everything from earlier diagnosis to better end-of-life care and new ways to help heal these damaged hearts is needed, the report says.

Swiggum said the Health Ministry is recognizing that supporting patients is needed.

“Sometimes it’s not a matter of more heart function clinics, it’s just supporting the ones that are already existing.”