Doctors and mayor call for cardiac lab in Nanaimo

Dr. Hesam Keshmiri, the sole cardiologist at the Nanaimo Regional General Hospital, is calling on the provincial government to commit to building a cardiac catheterization lab for the region at a press conference on Aug. 8, 2023. Photo: Mick Sweetman / CHLY 101.7FM

Dr. Hesam Keshmiri is the sole cardiologist at the Nanaimo Regional General Hospital (NRGH), which serves 450,000 people on Vancouver Island who live north of Duncan.

He says that he can’t provide the same standard of care people get in Victoria, because Nanaimo doesn’t have a cardiac catheterization lab.

Instead of a cath lab, where people can get lifesaving angiograms, Dr. Keshmiri is limited to using “clot busters” — a method that dates back to the 1980s.

“I had one case myself where a patient was given thrombolytics. But if we don't get an adequate response then we try to ship them over to Victoria to have what we call a rescue PCI,” he said. ”Unfortunately that patient did not respond to the thrombolytics and on their way to Royal Jubilee Hospital they had an intracranial bleed and they died.”

Dr. David Coupland, president of the Nanaimo Regional General Hospital Staff Association, joined Dr. Keshmiri and local politicians at a press conference on Tuesday.

According to Coupland, a review of cardiac care in Nanaimo by the Ottawa Heart Institute in 2006 found that three per cent of patients at NRGH died unnecessarily without a cath lab.

“The inequity is obvious,” said Dr. Coupland. “We have the largest population we know of in Canada without timely access to a cardiac cath lab.”

Coupland says that people suffering from a major heart attack only have 90 minutes to open the blocked arteries.

“This rarely happens for patients in the central and north Island who are hours away from our cardiac cath lab over a mountain,” he said. “The lack of cardiac services leads to undue harm to our patients, higher morbidity, mortality, poorer quality of life, and increased cost to patients and the system.”

Snuneymux Chief Michael Wyse needed an aortic valve in his heart replaced last year, but had to travel to Victoria for the procedure.

“It is clear that a central Island cath lab is a necessity,” he said. “It is essential in ensuring that our community members receive the prompt care they need when they face cardiac emergencies.”

Dr. Keshmiri says that people with a history of heart disease should reconsider moving to central or north Vancouver Island.

“I would honestly tell them to think twice about it,” he said. “Because it is something that I've seen over and over, especially a lot of patients who are coming from outside of the province to Nanaimo or the surrounding area, they just don't really know what they're getting themselves into.”

Nanaimo Mayor Leonard Krog said that the disparity in care concerns him.

“We're rather like a third world country on the other side of the Malahat,” he said. “We are not receiving the kind of world class care that you get in the city of Victoria or if you live in the southern part of the island, on the other side of the Malahat.”

Regional Hospital District Board Chair Ian Thorpe says the local hospital levy has more than doubled from $16 for every $100,000 of assessed property value in 2016 to $35.18 to help pay for improvements to the hospital.

“Usually politicians won't stand up and brag about tax increases,” he said. “But this is one that I am happy to talk about and happy to defend, because it represents a huge statement of our commitment to health-care projects here.”

Minister of Health Adrian Dix was unavailable for an interview but said in a statement that a new cardiologist recently began working in the central island region and an additional cardiologist is scheduled to start at NRGH in September.

Dix says that NRGH has the ability to perform a number of cardiac diagnostic procedures, while the Royal Jubilee Hospital is the designated cardiac care center for the Island where specialized treatment, procedures and equipment are available.

As for Dr. Keshmiri, he isn’t looking forward to the next time he has to tell a family member that their loved one needlessly died.

“I tell all of them that they really need to strongly advocate, they need to write to their MPs, they need to make everyone aware that this happened to their families,” he said. “They need to raise their voice so that hopefully positive changes can be made so that this doesn't happen to other family members.”

Funding Note: This story was produced with funding support from the Local Journalism Initiative, administered by the Community Radio Fund of Canada.