Heart specialist urges Barbadians to change their lifestyles.

A dramatic increase in cardiovascular cases is straining the Queen Elizabeth Hospital’s resources, the QEH’s top cardiologist has said.

Dr Dawn Scantlebury, the head of the Department of Cardiovascular Services, has reported a stark increase in heart attacks, which were once a rarity but are now reported more than once daily, as Barbadians’ changing lifestyles and diet deepen an epidemic of chronic illnesses.

“Back in the 70s, when cardiology was in its infancy in Barbados and the cardiac unit was first established, the predominant cardiovascular disease that we were seeing was rheumatic heart disease,” Dr Scantlebury told the QEH Pulse Radio show. “It was related to infection, and it was fairly common but not that common. We did not have that degree of burden. Heart attacks were few and far between, and those were for the visitor.

“Now what we’re seeing, is more than a heart attack a day. Either patients dying suddenly at home or coming in with sudden chest pain, etcetera. Coronary disease, which was again unheard of back in the 70s and 80s, is exceedingly common, and some of that relates to the change in our lifestyle.”

The QEH is now treating a wide range of cardiovascular conditions, including coronary disease, heart failure, and abnormal heart rhythms such as atrial fibrillation and ventricular tachycardia. Sudden cardiac death has also become a significant concern.

Dr Scantlebury, who also serves as the first vice president of the Heart and Stroke Foundation of Barbados, highlighted a troubling trend: “When you think of cardiovascular disease and heart attacks, a lot of people think that it’s not their problem because it’s a problem of old people, but it’s not. We see people from early on, paediatric age, yes, but the age at which people are developing heart disease, heart attacks, and heart failure is dropping, and you can see it in men, you can see it in women, you can see it in young mothers, you see it in everybody.”

The rise in cardiovascular cases is putting a significant strain on the island’s lone public hospital’s resources. Director of Medical Services Tony Harris noted the stark contrast with the past: “When in the medical ICU in 1971, heart attacks were relatively infrequent, occurring perhaps once a week. Today, however, the unit was dealing with more than one heart attack a day.”

Harris further explained the broader impact on the healthcare system: “We know that at the hospital, there is always certainly a big demand for critical care beds to take care of these kinds of conditions. That is just heart disease; that does not even talk about stroke. Stroke in our population is probably even more prevalent than heart attacks and stuff like that. So it is something that we have to grapple with, and of course, the other thing is that you get kidney failure and stuff from the NCD, hypertension, and diabetes, and that is also rising at a phenomenal rate.”

Both Dr Scantlebury and Harris emphasised the need for lifestyle modifications and patient education to manage cardiovascular health. “We have to do a lot of education; it’s a daily thing,” said Dr Scantlebury. “For everyone that I see, there is some discussion on physical activity; there’s a discussion on diet, even if it’s the diet that they need to avoid worsening of their condition.

The foundation of management still remains that lifestyle. So I often tell patients that you need to go back to the earth as far as healthy eating—more plant-based [foods]. You can help us a lot as far as management of cholesterol, diabetes, and hypertension, and you can actually help reduce your pill burden, meaning the number of tablets you’re taking, by really taking your health into your own hands and back into your control.”

The QEH cardiology unit offers a range of services, from non-invasive tests to invasive procedures such as angioplasty and stenting. But the department faces significant challenges related to staffing and resources, its chief added.

Harris noted that efforts are underway to address these challenges: “Back in 2018, we began assessing the expected load and demand for cardiology services and successfully advocated for expanded staffing. We are working to enhance our staffing levels in medical, nursing, and technical areas to better address the rising demand for cardiac care”.

Dr Scantlebury stressed the need for ongoing innovation and education: “We need to continue innovating and educating both patients and healthcare providers to manage the increasing burden of cardiovascular disease effectively. Our goal is to provide the best possible care and adapt to the evolving landscape of heart disease.”