Your heart is the engine room of your wellbeing and requires regular maintenance to make sure it stays in perfect shape.
Chest pain, arrhythmia and heart failure are the main reasons people present for heart health investigations at Blackrock Health’s Rapid Cardiac Care Service.
According to research carried out by the healthcare group over three-quarters of those interviewed, 77 per cent, experienced one of the symptoms associated with chest pain, arrhythmia and heart failure. Yet almost 20 per cent of those same interviewees did not take any action.
Worrying cardiac symptoms should never be ignored but swift access to a team of cardiovascular specialists is not always guaranteed.
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But that’s what is available at the consultant-led Blackrock Health Rapid Cardiac Care service, which offers concerned patients the promise of a comprehensive cardiology assessment and either peace of mind or a highly individualised care plan if it is required.
There are a range of signs and symptoms that could indicate a cardiac issue, says Dr Daniel O’Hare, consultant cardiologist at the Blackrock Health, which combines Hermitage, Blackrock and Galway clinics.
The main one is chest pain. “This is pain that can be felt in the centre of the chest and perhaps even the arms and the neck or even at the top of the stomach,” he says. “There are certain red flags that mean this is more likely to be cardiac chest pain, such as pain lasting more than 15 minutes or pain that recurs within one hour.”
Cardiac symptoms can overlap with symptoms of other conditions. O’Hare acknowledges that it can be difficult for patients to differentiate this red flag pain from other sources, hence why it is always a good idea to have any new-onset chest pain investigated. “Any form of chest pain should be taken seriously especially in patients with known cardiovascular risk factors such as high blood pressure, high cholesterol, diabetes, a history of smoking or a family history of heart problems.”
“Palpitations or the sensation of an irregular pulse may be the sign of an abnormal cardiac rhythm. The most common rhythm problem is called atrial fibrillation which can increase your risk of stroke. Early diagnosis and treatment of atrial fibrillation improves outcomes.”
Another common symptom is any abnormal or new shortness of breath on exertion or at rest. “This can be a sign of cardiac issues, either poor blood supply to the heart muscle or heart failure,” says O’Hare.
O’Hare adds that patients either come to the rapid cardiac care service via referral from their GP or else they can self-refer. “It may be that their GP has carried out an assessment and deemed that specialist cardiac input is required, or patients can also self-refer in two ways – by calling the rapid cardiac care unit and speaking to one of the clinical specialist nurses to see if they would be an appropriate patient, or else simply presenting to the service, where they will be triaged.”
The goal of the Rapid Cardiac Care Service is to determine if there is an underlying cardiac cause for the patient’s symptoms. Ann Copeland, one of the clinical nurse specialists at Blackrock Health, explains that patients are typically seen “within the first 15 minutes of presentation”, their vital signs are taken and an electrocardiogram (ECG), which checks the heart’s rhythm and electrical activity, is performed to rule out anything acute such as a heart attack.
If nothing urgent shows up on the ECG blood tests are carried out to check cholesterol levels as well as cardiac enzymes, which may indicate an issue. A thorough clinical examination is carried out and a family history taken, adds Copeland.
“Depending on the main presenting symptoms, the most appropriate investigations are performed For example, if they have palpitations they might be given a prolonged cardiac rhythm monitor, (often called a Holter monitor), or if tests indicate that there may be a problem with blood flow in the coronary arteries the patient may have to undergo further investigations in the cardiac catheterisation lab, such as an angiogram.
All of these investigations can be carried out on-site on the very same day, says O’Hare.
“Time is prioritised once these patients present. The cardiology consultant is always on site, and can be there within minutes if there is an urgent patient.” Specialist cardiac nurses triage patients at each stage, he adds.
The results of the various investigations will be interpreted by the consultant on duty, and these can be reassuring or else may indicate that further testing is required. “The patient plan is very specific to each patient we see, tailored to the results we see on the day,” O’Hare says.
Copeland says on average about 20 per cent of those who present to the rapid cardiac care service are admitted to the hospital, sometimes for an important procedure.
“An angiogram might be performed which may show stents are required, or we often have pacemakers implanted urgently on the same day. Sometimes we carry out cardioversions where we ‘reset’ the patient’s heart.”
Other patients may be discharged but will return for follow-up care such as ongoing heart failure management.
Copeland says communication with often-worried patients is key. “We explain to the patient what each procedure entails and what it is hoping to determine, and then we carefully explain the plan of care going forward.”
O’Hare is adamant that people who experience any abnormal cardiac symptoms should not feel they are “overreacting” by presenting to their GP or to hospital.
“Cardiovascular disease is the leading cause of death in Europe, and within cardiovascular disease, ischemic heart disease, where blood flow to the heart is impaired, is the leading cause of mortality,” he says. “We know that prevention and acting on early signs and symptoms can reduce the morbidity and mortality associated with cardiovascular disease. We take chest pain and those symptoms very seriously. If you are worried then you should get it checked out, and often an assessment and talking to a health professional can alleviate some of that worry.”
Blackrock Health’s Rapid Cardiac Care service is available across Blackrock Clinic, Galway Clinic and Hermitage Clinic. For more information, call 1800 911 985 or visit blackrockhealth.com