King Edward VII Memorial Hospital Supports Heart Month

KEMH Offers Blood Pressure Screenings, Hosts Symposium for Nurses and Highlights its First-Class Cardiac Diagnostic Unit

In support of the Bermuda Heart Foundation’s Go Red For Women campaign to mobilize women for heart disease awareness, the Bermuda Hospitals Board (BHB) is offering blood pressure, blood cholesterol and blood sugar screenings for the community in the King Edward VII Memorial Hospital (KEMH) lobby on February 9th and 23rd from 12:00 pm to 2:00 pm In addition, the BHB is hosting the 2005 Cardiology Symposium for Nurses on February 25, where members of the world-renowned Johns Hopkins Hospital Heart Failure Team will be discussing various aspects of heart failure management.

“February is Heart Month in Bermuda – a time when hospitals and health care providers focus on educating the public about cardiovascular disease. At KEMH’s Cardiac Diagnostic Unit, we recognize the importance of educating the public about heart health and the value of healthy lifestyles,” said Dr. Shane Marshall, Cardiologist and Director of Cardiac Care at King Edward VII Memorial Hospital.

Spotlight on KEMH’s Cardiac Diagnostic Unit
Thanks to the generosity of Mr. David Barber, the Cardiac Diagnostic Unit was built (in memory of his late wife Mary) and officially opened in September 2002.

A total of 14,485 tests were conducted at KEMH’s state-of-the-art Cardiac Diagnostic Unit (CDU) in 2004. The CDU is responsible for non-invasive cardiac testing. Electrocardiograms (ECG), Holter Monitoring, Stress Tests, Echocardiograms (Echo), Stress Echocardiograms and Pacemaker Analysis are all performed at the CDU. All patients must be referred by their general practitioner, internist or cardiologist before having a test.

Tests Performed at KEMH’s Cardiac Diagnostic Unit
The Electrocardiogram (ECG) is the most commonly performed cardiac test in the CDU. It is a useful screening tool used to establish a baseline during routine physicals or pre–operative testing, and also for a variety of cardiac abnormalities that can occur.

The test is very quick and involves electrodes being placed on the chest, arms and legs. The ECG machine produces a tracing of the heart’s electrical impulses. It measures the heart rate and rhythm and is often used to determine if a person is having, or has had, a heart attack. The test also examines conduction abnormalities from the impulses of the heart.

The Holter Monitor is used when a person requires ECG monitoring for a longer period of time. Electrodes and a tape recorder (which resembles a portable Walkman) are attached to the patient. When sent home, the patient is allowed to resume normal activities. The monitor is worn for 24 hours and the patient is asked to record any symptoms, including the time and type of activity during this period. The patient returns to CDU at the same time the following day to have the monitor removed. The disk is removed from the monitor and analyzed for abnormalities.

Some forms of cardiac disease are easily missed when the patient is at rest and may become apparent only when the heart rate or workload is increased. Therefore, a physician may recommend an Exercise Stress Test to check for underlying coronary artery disease. Electrodes are attached to the chest and the patient is required to walk on a treadmill. Throughout the test the patient’s blood pressure is monitored and ECG tracings are taken at various intervals. A doctor is present during the entire test to monitor the exam and the patient will be asked to report any symptoms that may be experienced. After the test, the patient is monitored until the heart rate (pulse), blood pressure and ECG return to baseline (normal) and until symptoms disappear (if occurred).

The Echocardiogram (ECHO) is an extremely useful test for studying the heart’s anatomy (structure) and function. It is a longer test that can take anywhere from 30 minutes to 1 hour to perform. The test is safe, as no radiation is involved, and uses ultrasound technology to obtain images and measurements of the heart. The patient will lie on his or her left side, in a semi-darkened room and a transducer (which resembles a flashlight) along with cool gel, will be moved around the chest and abdominal areas. Moving pictures of the heart and the sound of the blood flow can be seen and heard from the television-like monitor. The pictures are recorded onto a videotape or disk for later review by the cardiologist. Echocardiograms are performed on people of all age groups ranging from newborns to adults and are most commonly used to detect congenital abnormalities, problems with the valves of the heart, and in pinpointing the areas of the heart muscle that may or may not have been damaged as a result of a heart attack. The echo is also useful in assessing various other cardiac abnormalities.

Echocardiograms are also done in conjunction with an Exercise Stress Test. This test is known as a Stress Echocardiogram and is only performed when the patient has had the two former tests. Echo images of the heart are taken before and immediately after the patient exercises on the treadmill. The Cardiologist is present for the entire exam and will compare the resting pictures to the pictures taken after exercise. If the patient is on a beta blocker (a type of high blood pressure medication) then they will be asked to miss 2 doses prior to having the test. The stress echo is very reliable in detecting underlying coronary artery disease.

All of the tests performed in the CDU are safe, pain-free and non-invasive. The tests are reviewed by the interpreting Cardiologist or Internist each day and a typed report of the results is sent to the patient’s doctor.

“We are very fortunate in Bermuda to have a first-class Cardiac Diagnostic Unit that is staff by a highly-skilled and dedicated staff,” said Joan Dillas-Wright, Chief Executive Officer of the Bermuda Hospitals Board. “Heart Month is an excellent opportunity to spotlight our CDU as part of an initiative to educate the public about cardiovascular disease.”

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