Eden’s heart scare shows health care system issues

A heart scare that sent Cayman Islands Health Minister Anthony Eden to a Miami hospital earlier this month showed up both the good and the bad in the Cayman Islands health system.

According to doctors here who examined the minister, Mr. Eden did the right thing. He followed his doctors’ advice, came in when early warning signs showed themselves and got tested for heart problems before the worst happened.

Dr. Fiona Robertson said this is what she would advise all patients to do.

‘Chest pain isn’t something you want to ignore,’ she said. ‘Once you have a heart attack there’s much less options for you then if you get here before.’

Cayman Islands hospitals also have fewer options than many in the United States when it comes to treating patients after a heart attack.

‘We don’t have interventional cardiology, nobody on the island does,’ Dr. Robertson said.

The invasive medical procedure used to clear Mr. Eden’s blocked artery, Miami doctors essentially had to go in through his arm and install a stent to keep the artery open, could not have been done in Cayman.

The Health Services Authority will use a non-invasive ‘clot-busting’ technique in the case of a patient being rushed into the emergency room suffering from a heart attack.

If a patient needs a more drastic, invasive procedure they must be flown off-island. Dr. Robertson said that’s obviously not the ideal situation since there’s generally a two-hour window or less available to operate in most cardiac arrest cases.

Hiring someone in Cayman to do invasive procedures full time is not only costly, it could also be ineffective.

‘If we brought someone down they might do about three months’ work and then they’d run out of patients,’ Dr. Robertson said. ‘We want the person who is doing it everyday, because they’re the best, the most experienced.’

Also, Dr. Robertson pointed out that if something goes wrong during a surgery, a cardio team should be on standby in event an artery must be repaired due to surgical damage. That would add more cost and might not be needed save in one or two cases a year, she said.

Early testing and intervention is what the doctor orders for patients in Cayman.

‘People haven’t quite got the idea that we can pick these things up a little earlier than when you’re having a heart attack,’ Dr. Robertson said. ‘People should look at their weight, their cholesterols and their exercise because the long-term risk of you having a heart attack is less if you look after the numbers.’

In Mr. Eden’s case, doctors used a machine known as a ‘stress Electrocardiogram’ or EKG to measure his heart rate as he walked on a treadmill. The machine showed up some concerning signs, but doctors had no way of determining how much of artery was blocked.

‘But we had a very good idea that the block was not a minor block,’ Dr. Robertson said. ‘I wouldn’t have liked him to being going around for very much longer (without getting treated).’

Minister Eden, in an earlier interview with the Caymanian Compass, said he considered himself a ‘blessed man’ and said he now feels ready to finish out the political campaign.

“People should look at their weight, their cholesterols and their exercise because the long-term risk of you having a heart attack is less if you look after the numbers.” – Dr. Fiona Robertson