Even as the first bricks have still yet to be laid for the new RM300 million 10-storey Women, Children & Cardiology block which will house the cardiology unit of Hospital Raja Permaisuri Bainun (HRPB), Ipoh, heart patients in Perak have been receiving treatment at the hospital’s Pusat Rawatan Harian (Day Care Centre) since January 31, 2013.

On the opening day of the new cardiology unit, five cases of Diagnostic Angiography were performed, a milestone for HRPB which has all these while referred heart patients to the National Heart Institute (IJN) as well as Serdang and Penang Hospitals.

The initial two treatments for Percutaneous Coronary Angioplasty (PCI) were carried out on February 1, 2013.

Until August 31, 2015, a total of 3,698 cases were for Diagnostic Angiography while for PCI, 1,389 cases.

Perak State Executive Councillor for Health Dato’ Dr. Mah Hang Soon was ecstatic to see the cardiology unit taking shape. He said, “As a cardiologist, I am very pleased to be able to garner the Health Ministry’s support in providing this long-awaited health service for Perakians.

photo courtesy of Perak Today

photo courtesy of Perak Today

“This cardiology unit lowers the cost of treatment for heart patients. Patients no longer have to travel to heart specialist centres out of state like they used to, thus reducing the burden on family members. Patients that require coronary artery bypass graft (CABG) operation are now referred to IJN because we do not have a cardiothoracic surgeon yet. Very importantly, this cardiology unit can handle emergencies. In heart cases, time is of the essence to prevent the impairment of the heart muscle and its function. Therefore, swift action is required.”

To date, RM30 million has been allocated to the unit by the Health Ministry over the last four years. According to statistics, the cardiology unit at HRPB has done the second highest number of invasive cardiac procedures among all nine cardiology units in government hospitals in the country after Serdang Hospital, for the first half of 2015.

This Cardiology Unit has five sections: Coronary Care Unit (CCU), Cardiac Rehabilitation Ward (CRW), Non-invasive Cardiac Laboratory (NICL), Invasive Cardiac Catheterisation Laboratory (ICL) and Cardiology Clinic for follow-up cases.

Headed by resident consultant cardiologist Dr. Asri Ranga Abdullah Ramaiah, who was transferred to HRPB from Serdang Hospital in August 2011, he is assisted by four cardiology fellows, two medical officers and a team of specially-trained nurses.

The unit’s ICL is equipped with a biplane angiography system, the only one in Perak, to visualise coronary artery inside the human body; to show blockage(s) and condition of the patient’s coronary arteries.

At the second of the four-phase project now, the cardiology unit is expected to expand its cardiac services to include Electrophysiology, Cardiac Imaging and Paediatric Cardiology some time in 2018 as well as Cardiothoracic Services in the final phase in 2020.

Said Dr. Asri, “Currently, the cardiology unit is able to handle about 95% of PCI cases, including “rescue” PCI and “primary” PCI. Not only do we see patients who live nearby, we also attend to referrals from fourteen district hospitals in Perak. When the new hospital block is completed some time in 2018 and the cardiology unit is furnished to provide Cardiothoracic Services, we believe that we will then be able to provide top notch cardiology health services comparable to other heart specialist centres in the country.

“The problem we are facing now is that we are lacking of manpower, especially an additional two consultant cardiologists to handle the increasing number of patients.”

Most of the cases referred by district hospitals are from Manjung, Slim River, Teluk Intan and Taiping. In fact, Taiping has such a high number of cases that a Visiting Cardiology Clinic has been established whereby a cardiologist visits once every three months.

Angiogram and angioplasty procedures performed at HRPB’s cardiology unit cost a fraction of what are charged by private hospitals as charges in government hospitals are standardised by the Health Ministry. Malaysian patients who are referred by other government hospitals are charged RM75 while those referred to HRPB by private hospitals have to pay RM200 for an angiogram procedure.

Those undergoing angioplasty using normal stent pay at least another RM200. On the other hand, those requiring a special drug-eluting stent (DES) pay RM5,000 per stent. However, in an emergency case, the stent charges could be waived.

Patients, for non-urgent cases, in need of welfare assistance are referred to the hospital’s Medical Social Welfare Unit. It takes two to three months for the approval from “Tabung Bantuan Perubatan” under the Ministry of Health.

Patients with severe triple-vessel disease who are not suitable for PCI but require a bypass operation are now referred to IJN or University Malaya Medical Centre. Based on statistics from HRPB, 40% of the heart patients seen here need PCI, 30% require an operation while 30% are treated by medication.

According to the latest data published by the World Health Organization (WHO) in May 2014, death from Cardiovascular Diseases (CVDs) in Malaysia reached 29,363 or 23.10% of total deaths, ranking the country #33 in the world. The number one culprit of heart diseases is believed to be an unhealthy lifestyle that includes physical inactivity, smoking, diabetes and obesity. A few ways to lower the risk of heart diseases are to keep active with at least thirty minutes of exercise daily, maintain a healthy weight, quit smoking and stress management.

Note: An edited version of this article [Hearty milestone for state hospital] was published on 24th October, 2015, in the now-defunct The Malay Mail.

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