WINDHOEK- Starting yesterday (July 1), the newly opened Heart Attack Centre at the Roman Catholic Hospital started providing emergency services to patients with suspected or confirmed heart attack. State patients with similar symptoms will receive these services at Katutura hospital. New Era (NE) senior journalist Alvine Kapitako talked to cardiologist, Dr Simon Beshir (SB) on the newly opened Heart Attack Centre.
NE: What exactly is “heart attack?”
SB: “Your heart need constant supply of blood, oxygen and nutrients. There are usually three, relatively small (2-5mm in diameter) arteries on the heart surface that are bringing blood to the constantly working heart muscle. These ‘coronary’ arteries may get gradually narrowed by cholesterol. It is usually at the spot where there is too much cholesterol where the artery may suddenly block by a blood clot. Blood then stops flowing to the heart muscle and the heart muscle starts dying. This is what we call the heart attack”.
NE: I would imagine that when a patient develops a heart attack, he needs treatment urgently?
SB: “Yes. As soon as the artery block, the time is clocking. The sooner we open the blocked artery, the better the chances of the patient for survival and for his or her heart to recover. We say that: ‘the time is muscle’. The artery can be opened by a clot- dissolving medication. This is called thrombolysis. But it must be deliver as soon as possible after the onset of symptoms. A better treatment is to open the artery with balloon and stent – this is called balloon angioplasty. That is what we do for heart attack patients at Roman Catholic Hospital”.
NE: How common are heart attacks in Namibia?
SB: “Very common and very frequent. Heart disease and heart attack is the leading cause of death worldwide and Namibia is no exception”.
NE: What are the symptoms of heart attack, how should the patients recognise it?
SB: “It depends on how big is the artery that is blocked. If it is one of the main heart arteries, the patient may die within a few minutes. This is called sudden cardiac death. Approximately 20 percent of patients who develop heart attack die instantly. But typical symptoms of a heart attack are: sudden onset chest pain, chest tightness or pressure on the chest. Usually associated with shortness of breath, sweating and fear of dying. But there are patients who do not have typical symptoms, especially diabetic and elderly patients. They may just feel a bit sick, tired and breathless”.
NE: How frequently do you deal with cases of heart attacks at the Roman Catholic Hospital?
SB: “Almost every day we have a patient with a heart attack. Some days are worse and there may be two or three patients coming with a heart attack”.
NE: What age groups are mostly at risk of a heart attack?
SB: “Heart attack affects mostly people from 50 years of age and above. But it can happen even to younger people. The youngest person I treated for heart attack was an 18- years-old male”.
NE: Which gender is mostly affected and are certain races, or tribes more likely to get a heart attack than others, and in Namibia which are those?
SB: “Both genders and all races and tribes can be affected. There may be some racial differences but we cannot support those observations by long term data. So it would be unwise for me to identify a particular group as the highest or lowest risk”.
NE: Do you receive patients from other countries at the Namibia Heart Centre or do you just treat Namibians?
SB: “We have treated foreign workers from various countries as well as tourists. We have also treated patients from Angola, Zambia and Zimbabwe but these patients came long after they had their heart attack and some of them already had irreversible damage to their heart muscle”.
NE: How costly is it to treat a patient with heart disease and what is the alternative for those who cannot afford?
SB: “The technology, drugs and materials (catheters, balloons, stents) are quite costly. So modern treatment of heart attack is expensive. We must import almost everything from abroad and the end-customers (our patients) are also paying the commissions of suppliers (RSA, Namibia) and the import tax. Medical aids, including PSEMAS, do cover the treatment of heart attack fully. State patients are currently treated at Windhoek Central Hospital but we are preparing a proposal for the government that would allow us to treat state patients with acute heart attack at our Heart Attack Centre at Roman Catholic Hospital as well. Private patients have to pay from their pocket, but we have prepared a special package and repayment system for them. The idea is to remove the financial issue from the urgent management of patients suffering from a heart attack”.
NE: What kinds of experts do you have at the Heart Attack Centre and what type of equipment are available there?
SB: “We have the latest, state-of-the-art, equipment at Roman Catholic Hospital. Our centre is equal to those in EU, UK or USA. We also have a well trained and experienced cardiac team at Roman Catholic Hospital. In fact, all the staff at Roman Catholic Hospital is by now used to deal with heart patients. We have had zero mortality at our CathLab so far and our patients have not required an emergency bail-out heart operation in the last six years”.
NE: Also tell us what is the motive for starting a Heart Attack Centre?
SB: “We have been treating patients with heart attacks for years. But we have seen far too many patients coming too late (when their heart was already damaged) or not making it to us at all. Frequently patients were admitted to hospitals without the necessary equipment and expertise. This just increases delays in the management as well as the total cost. So our aim is to improve the management of heart attack patients, to reduce the time from the symptoms to the treatment that opens the blocked artery, to save more hearts and more lives. This is just a start. We want to improve our Heart Attack service at Roman Catholic Hospital, learn from experience and make it accessible to all Namibians. So that when they call our emergency number 085911, they will get the immediate and appropriate treatment and they will be able to reach us in time”.