Heart attack patients in Waterford have ‘almost no chance’ of receiving life-saving treatment in a timely manner


People who have a heart attack outside office hours in Waterford have virtually no chance of accessing life-saving treatment in a timely manner as they have to be transferred to Cork.

That’s according to Paddy Owens, cardiology consultant at University Hospital Waterford (UHW), who was speaking after the latest national audit revealed that treatment for major heart attacks should be given within 120 minutes of the first medical contact for the patient.

The Irish National Heart Attack Report analyzed 5,629 patients between 2017 and 2020. It found that patients who received “timely” primary percutaneous coronary intervention (PPCI) had an in-hospital mortality rate of 2.8 %, “compared to 5.2% in patients treated beyond the 120-minute window”.

Emergency PPCI treatment involves inserting a wire into the blocked artery and is given at 10 specialist centers across Ireland, including Cork, Limerick, Waterford and Dublin.

The particular difficulty encountered by doctors and their patients in Waterford is that the PPCI laboratory only operates during office hours from Monday to Friday. Photo: Larry Cummins

It is considered the gold standard for those who suffer from major heart attacks.

Dr Owens told the Irish Examiner the most important thing for a person suffering from a heart attack is to access this treatment as soon as possible, otherwise there is a risk of serious long-term health damage.

However, the Waterford PPCI lab only operates Monday to Friday, 9am to 5pm. Activists in Waterford and the wider region have been pushing for a 24/7 cath lab for several years due to the lack of coverage outside these hours.

A national review of cardiac services has been commissioned as a result of the campaign and is due to be published in the coming weeks.

Dr Owens, who is part of the campaign for 24-hour cath lab service, said a ‘main message’ everyone should take away from the audit is that the sooner you get first medical contact , the more likely you are to survive a heart attack. .

A heart patient, Ciarán Murphy, had to be transferred to Cork after suffering a heart attack on a Sunday in late 2019. He was brought in by helicopter for the PPCI. He told the Irish Examiner his doctor said his heart had lost 25% use.

“It baffles me after all this time that they’re actually looking at this,” he said of the national exam, which was originally ordered in 2017. “They’re just dragging their heels as far as I can see.”

The cath lab is set to move to 8am-8pm after a lengthy recruitment drive, but Mr Murphy said it was just “dribs and drabs” rather than the full service campaigners are looking for.

They need to put 24/7 in UHW and just go on and employ people to make it viable.

Dr Owens said heart attack patients are ‘still much better off, even if it’s just a matter of minutes’ in the difference for emergency treatment, as there are views differ on whether 120 minutes or 90 minutes are acceptable times for a patient to receive an intervention. .

“At 90 minutes or 120 minutes, even in that two-hour interval, you do much better if you get to the hospital as soon as possible,” he said. “So whichever way you slice it, you’re still much more likely to travel to Waterford if it provides the main PCI if you’re in the South East than you are if you’re traveling to Dublin or in Cork.”

He warned that this week’s audit does not contain information on ‘direct transfer time’, where an ambulance can bring a patient directly to Dublin or Cork instead of a local hospital.

We don’t know how long this transfer takes…I suspect it’s still very long and noticeably longer than would be ideal.

Transfer time “ultimately forms the core of our argument”, Dr. Owens added.

“As it stands, there is no mechanism to get patients to primary PCI centers in an acceptable time frame.”


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