QEH moves toward launch of heart failure service amid rising cases

Barbados is moving closer to establishing a long-discussed heart failure service at the Queen Elizabeth Hospital (QEH)as the country grapples with what Head of Cardiology Dr Dawn Scantlebury has described as an epidemic of the condition.

The initiative is being supported through a Memorandum of Understanding between the QEH and the Heart Failure Society of America (HFSA), which will provide free certification training for local nurses, junior doctors, pharmacists, and cardiologists in the management of heart failure. 

The programme includes guidance on diagnosis, optimal drug therapy, and patient monitoring, and is seen as a foundational step toward the roll-out of dedicated services.

Speaking during the Pulse radio show on Monday, Dr Scantlebury said Barbados is currently in an “active phase” of the heart failure epidemic, with the condition now one of the most common causes of hospital admissions and readmissions at the QEH.

“For years, we’ve been talking about how we can develop a heart failure service—whether it’s an early access clinic or a more advanced service that targets the sicker patients to reduce admissions. It’s been challenging, but what we’re doing now is getting our staff trained so we can finally put something concrete in place,” she shared.

The collaboration was facilitated by Dr Monique Robinson, a US-based heart failure and transplant cardiologist who was born in Barbados and trained at the University of the West Indies. 

Scantlebury said the two have been in ongoing dialogue about the crisis in Barbados and the need to build local capacity.

“She’s been trying to find a way to give back, and when we had a conversation about the heart failure scourge here, we realised this HFSA programme could be a game-changer,” she said.

“It’s normally a paid certification, but through her involvement, we’ve been able to access it at no cost for our core team.”

She noted that heart failure is a complex condition that requires early identification, careful investigation of its cause, and targeted drug therapy, which often includes a group of four key medications known as the “pillars” of treatment.

“What tends to happen is that we get these patients coming in for shortness of breath or chest discomfort, and after evaluation, it turns out to be heart failure. They’re investigated, stabilised, discharged, and then a few weeks later, they’re back. So, they take up a lot of our resources, particularly in internal medicine,” the heart specialist said.

Dr Scantlebury added that while countries like the US offer advanced treatment options such as heart transplants and ventricular assist devices (VADs), Barbados is currently limited to medical therapy due to cost and infrastructure constraints. This makes prevention and early intervention even more critical.

“Every new drug that’s shown to reduce mortality in heart failure is met with excitement by cardiologists because the end-stage is so devastating. Our goal is to prevent patients from getting to that point where the medications stop working,” she said.

The cardiologist issued a strong advisory to members of the public—particularly those living with heart failure—to monitor their symptoms closely and take early action.

“If you’re getting more short of breath than before, if your ankles are swelling, or you’re gaining weight quickly, those could be signs of fluid retention and worsening heart failure. Don’t wait. Call your doctor. Be proactive,” she warned.

She also urged the public to adopt healthier habits, including reducing salt intake and managing underlying conditions like high blood pressure, diabetes, and cholesterol, which can all lead to heart failure. 

(SM)