Cardiomegaly: HMC cardiac care expands

HILO — Cardiac services continue to expand at Hilo Medical Center, with a full panel of cardiologists now on staff and treating patients, and hospital officials are hoping to keep that momentum going.

HMC will seek $4 million from the state Legislature next session for a second catheterization lab in its Cardiac Clinic.

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“Our first lab is fully utilized and additional resources are needed to continue to save lives,” hospital spokeswoman Elena Cabatu said. “We want to ensure a lab is always available when heart attacks occur.”

HMC has long been working to treat cardiac patients closer to home and earlier this year hired its first interventional cardiologist, Carl Juneau.

Prior to Juneau’s arrival, HMC could administer clot-busting medications and perform diagnostic catheterizations to determine if a patient needed to be transported off-island, usually to Oahu.

The hospital can now perform interventional catheterizations to stop a heart attack in progress and insert stents to maintain blood flow.

Stent procedures have only been performed on nonemergent patients at HMC since January, starting shortly after Juneau’s arrival, and Juneau began performing such emergency interventions March 1.

Emergency cardiac procedures can now be performed all times.

Joining Juneau and rounding out the cardiology team are Dr. Jamison Wyatt, Dr. James Smith, Dr. T.J. Sawyer and nurse practitioner Terri Vrooman.

“I think it’s amazing,” Vrooman said. “To see what we’re doing for patients here, and to be on the ground floor, it’s a great opportunity and just the differences I can see being done every day, it makes me (know) that I made the right choice.”

“We had to build a program to support growing the service,” said Lauri Redus, regional imaging administrator at HMC. “We did that, I think, quicker than a lot of people ever thought that we would and so … we’re to the point that now we need to expand service. We’ve got to have another lab to be able to adequately take care of patients.”

Smith, the third cardiologist to arrive, shared those sentiments.

“It has been busy,” he said. “I think we’re getting busier, even at this point than we thought we were going to be at this point. … When the three of us would talk on the phone before we got out here, we knew that the potential to be busy was there. I don’t think we really understood just how much.”

Redus said HMC hopes the legislature “understands and supports the goals that we have, which is to be the cardiac care provide for this entire island.

“We are the hospital with these services,” she continued. “We want to grow this and make it available to all of the communities on this island and this is something we desperately need to be able to do that.”

According to Redus, patients are “vehement” about staying on island.

“We have people that come from Kona that are extremely grateful that they didn’t have to leave this island to get their care,” she said. “We need it. We need it to take care of our community. It’s really important.”

Mary Jane Llanes of Kailua-Kona was one of those grateful patients. She was transported by ambulance to HMC earlier this week after experiencing chest pains and underwent diagnostic catheterization.

She didn’t want to be transported off the island because her family is here “and if anything serious happens, I want them to be around,” she said.

HMC received $1.5 million from the state Legislature during its 2018 session to help bring the interventional cardiac catheterization program online and sought additional funding during the 2019 session, although that bill ultimately stalled.

“What we did was we managed our expenses and we managed our operations,” Cabatu said. “So we were able to welcome these four cardiologists and (nurse practitioner) and prop up the program and demonstrate the we do, in fact, need a second (catheterization lab).”

“I think that is one of the successes is that we operationally made this work with the funding that we originally got,” Redus said. “Even though we didn’t get the secondary funding we asked for, it also shows to me that this is truly the capacity we have to take care of patients here and we need to grow that capacity because the need is here.”

From Jan. 8 to Oct. 16, 286 heart catheterizations have been performed and 43 heart attacks treated. There have been more than 6,000 Cardiology Clinic appointments this year.

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“If we had to ship those people, they would not have lived,” Redus said of the 43 heart attack patients treated at the hospital. “… If we had to ship them to Oahu, the delay in care would have probably caused their death.”

Email Stephanie Salmons at ssalmons@hawaiitribune-herald.com.

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