CARDIOVASCULAR disease (CVD) prevalence has risen remarkably over the past 30 years, from 271 million in 1990 to 523 million in 2019, and CVD deaths have increased from 12.1 million in 1990 to 18.5 million in 2019. About 30 per cent of deaths from CVD are premature deaths affecting individuals between the ages of 30 and 70.

Even though CVD prevalence has risen globally, a disproportionate rise in CVD has been noted in low- and middle-income countries like Jamaica. While paying attention to prevention and maintaining ideal cardiovascular health is essential, we must now design proactive mechanisms for prompt response to acute and critical cardiovascular events that often lead to catastrophic outcomes in the absence of timely and proper intervention.

When individuals present with chest pain or similar symptoms it may signify underlying CVD and, possibly, an evolving acute event. While chest pain may not always be life-threatening, it is impossible to know without comprehensive evaluation by trained professionals. It would be unwise, therefore, to assume otherwise until a thorough assessment is performed. Comprehensive evaluation must be done urgently. Many individuals with chest pain, including those with heart attacks, are still delaying seeking care that could save their lives because of difficulties in accessing necessary care, either due to logistical or financial challenges. It is time to put an end to the unnecessary deaths and disabilities that result from delayed and inappropriate responses to cardiovascular disease and its complications. Delays in treatment can be very costly in money and life, but early intervention saves lives.

Are you at risk for a heart attack?

Key risk factors for heart diseases, including heart attacks, are: being of an age greater than 55, hypertension, diabetes, high cholesterol, smoking, a sedentary lifestyle, obesity, and family history. While individuals with multiple risk factors are at a higher risk for a heart attack, most individuals presenting with their first heart attack do not have multiple risk factors at the time of presentation. This means that you can also have a heart attack even if you are not aware of having risks such an episode. Therefore, it is essential to remain vigilant and respond appropriately if you or your loved ones experience symptoms suggesting the possibility of an acute cardiac event.

Where do you go for medical evaluation of chest pain or potential heart attack?

Home remedy is ineffective for chest pains or an acute cardiac event. All patients with chest pain or acute cardiac complaints should seek care from competent health-care professionals, preferably in facilities with adequate personnel and infrastructure for heart care and with a sense of urgency in addressing cardiovascular complaints. The choice of provider and facility for evaluating and treating your chest pain or cardiac complaint must be intentional as it may be the most critical decision that will determine the outcome of your care. Why? Because time is vital when chest pain has to do with the heart or major vessels. Delays could lead to death or severe complications, while a speedy and appropriate response will save lives and, most likely, avert significant complications.

Cost concerns impede universal access and timely intervention in heart care. Access and affordability are major barriers to timely and appropriate cardiovascular care delivery, especially for patients with acute coronary or other cardiac syndromes for whom timely intervention and comprehensive care are imperative.

Suppose we accept the universal doctrine that all lives are sacred and should be preserved at all costs? In that case, we must evolve mechanisms to align with this doctrine despite the cost and logistical challenges that impede access to care.

Health-care access is the ability to obtain needed care in a timely manner. This is critical in patients with acutely life-threatening conditions like heart attacks, especially in developing countries like Jamaica. Given the rise in chronic diseases, the increasing use of technology, and the ageing of our population, the economic cost of appropriate care is a huge problem. About 7,500 heart attacks occur each year in Jamaica, and many will not survive unless timely intervention is initiated. Our public hospitals receive many heart attack patients, and most of these facilities lack the infrastructure, resources, or human capital to respond to heart attack patients effectively.

For the private sector to play a meaningful role in improving access to care, critical factors that impede access must be eliminated. Any structure that delays or denies access to care is an impediment to care. The centrepiece of what we do as physicians must be the patient, which means all patients — not just a few. This is the basis of inclusive care and health equity.

Current health-care financing mechanisms in Jamaica do not offer adequate protection for patients faced with cardiovascular emergencies. In light of this, the Heart Institute of the Caribbean wishes to embark on a bold HIC Save A Life Programme initiative to fill the gap and ensure that most patients with acute cardiovascular emergencies have timely access to appropriate care.

The HIC Save a Life Programme is sponsored by the HIC Foundation to assist patients with acute coronary syndromes (including heart attack and unstable chest pain or angina) who urgently need life-saving treatment. This comprehensive heart care package is offered at a low, all-inclusive cost to ensure that patients with heart attacks and acute coronary syndromes get immediate access and timely intervention to save lives and avert complications.

Package includes:

Free ambulance pick-up from Kingston and St Andrew, Portmore and Spanish Town

Initial cardiology consultation

Electrocardiogram

Continuous cardiac monitoring

Cardiac catheterisation and coronary angiogram

Coronary angioplasty with drug-eluting stent

All surgeon’s and technical fees

All operating room charges

All nursing and technical fees

All surgical consumables and medications

Two to three days’ admission in the ICU or telemetry at no cost

All patient meals and medications while admitted

Free, unlimited cardiology consultations for 60 days after discharge

Availability 24/7.

To learn more or to take advantage of this offer, we encourage individuals to call the Heart Institute of the Caribbean at 876-906-2105 to 2108.

Today’s key takeaway message in our article is that chest pain or other acute cardiac complaints can and will kill if proper and timely intervention is not initiated. Furthermore, we have now taken a bold step to open access to individuals with acute cardiac complaints so as to minimise the logistical and financial challenges.

Dr Ernest Madu, MD, FACC and Dr Paul Edwards, MD, FACC are consultant cardiologists for the Heart Institute of the Caribbean (HIC) and HIC Heart Hospital. HIC is the regional centre of excellence for cardiovascular care in the English-speaking Caribbean and has pioneered a transformation in the way cardiovascular care is delivered in the region. HIC Heart Hospital is registered by the Ministry of Health and Wellness and is the only heart hospital in Jamaica. Send correspondence to info@caribbeanheart.com or call 876-906-2107.