When Gordon McDougall started to feel the familiar signs: sweatiness, upset stomach, shortness of breath; coming on during a walk around Matheson Lake in September 2015, he knew his heart was in trouble – again.
“I simply passed out,” he said, having suffered cardiac arrest after three previous heart attacks.
McDougall was transported to Royal Jubilee Hospital, the Heart Health Centre of Excellence, where the cardiac health unit has been on the forefront of clinical trials in North America since performing its first cardiac operation in 1973.
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Today, it is the only centre in Canada conducting research that has led to advances and innovation in how to treat heart disease, the second leading cause of death and the leading cause of hospitalization in the country.
“We don’t get paid for it, we do it because we want to do it,” interventional cardiologist Dr. Anthony Della Siega said during “Getting to the Heart of the Matter: Advances in Cardiac Care,” a presentation held recently at RJH.
While the cardiac surgery program performs coronary bypass procedures, heart valve replacements and aortic aneurysm repair – some 725 procedures per year – Della Siega and a team of cardiologists are also at work finding better, more efficient ways to treat heart patients.
Victoria tends to punch well above its weight, Della Siega said, pointing to the pioneering of performing angiograms through the wrist, a common practice now worldwide.
The drive to push, to innovate is what “we learn in medical school,” he added.
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Dr. Chris Franco, a general cardiologist, said the question now is how to get ahead of ailments like premature coronary artery disease (CAD), his area of study. The arteries of individuals as young as 16 to 22 can have plaque present – its buildup narrows arteries, decreasing blood flow to the heart.
The offspring of a person with early heart disease has double the risk of developing the same issue. Screening family members is where prevention comes into the discussion, Franco said, citing Save BC, an ongoing study to avoid cardiovascular events.
“We’re working on recruitment through the Victoria Heart Institute Foundation to bring this project to Victoria,” Franco explained. “What we aim to do is develop diagnostic and therapeutic approaches to manage premature coronary disease.”
Ongoing follow-up methods for participants and their family members will involve both treatment and study, to understand the factors that contribute to CAD going forward.
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Bilal Iqbal, an interventional cardiologist and leading researcher at Royal Jubilee, has a vision.
“In three to five years’ time I want to be able to say Victoria is a hub for research and it’s got international recognition.”
Coronary disease is present in 2.4 million Canadians, and of those who don’t have it, 90 per cent have at least one risk factor in developing it (high blood pressure, high cholesterol, diabetes, smoking, increasing age), while 40 per cent of people have two.
The kind of research RJH has embarked on, and a continued drive to understand how the heart works; still, heart disease continues to pose a significant health care and economic burden.
“Interventional cardiology is a highly evolving specialty,” he said. “All of this has been possible because of research … mostly by relying on grant bodies and donations.”
In a 2016 study using the data of 6,503 patients in B.C. with a history of heart disease and heart attacks, Iqbal found only treating the blocked artery resulted in better outcomes.
“We’ve got all the expertise and the skills here,” said Iqbal, whose goals include starting molecular research in Victoria, and developing a PhD research training program.
Victoria is unique in that it offers access to emergency procedures – in one case, the time from which a patient arrived at Royal Jubilee and underwent a “balloon treatment” to open a blocked heart valve, was just 13 minutes.
“We want to make [patients] live longer, feel better and do both if we can,” Della Siega said, adding that no longer is the medical community only looking to big centres like McGill and Toronto to lead in advances.
“We have many things to achieve here and we’re well on our way.”