10 YEARS LATER: Re-imagined Cardiology Program finds its rhythm

Elizabeth Fielding (left) is with Registered Nurse Lesley Stamper in the Heart Investigation Unit at the St. Catharines Site. Elizabeth's husband, Ian, was able to receive care close to home because of the services Niagara Health added to its Cardiology Program when the hospital opened in 2013. 

Ian Fielding wasn’t the type to choose sitting on the couch over an intense game of squash or hitting the links with friends.

So it didn’t make sense to the Niagara Falls man when he experienced shortness of breath while golfing one day in 2016. However, it did make him pause long enough to call his wife Elizabeth and ask that she book him a doctor’s appointment. 

That led Ian, whose daughter, Elayn Young, is Director of Critical Care, Cardiology, Respirology and Trillium Gift of Life at Niagara Health, to undergo a stress test at the Niagara Falls Site, where he was immediately admitted to the Intensive Care Unit for heart failure. Once he was well enough, Fielding was referred to the Heart Investigation Unit at the St. Catharines Site for ongoing care close to home.

That type of care would have meant traveling outside the region before Niagara Health established a comprehensive, regional Cardiology Program when the St. Catharines Site opened in 2013. And it’s care that Elizabeth would have had difficulty co-ordinating travel to had Ian needed to go elsewhere.

“I can’t say enough about the treatment he received here,” Elizabeth said. “When he had to go to an appointment, he was comfortable coming here. Everyone he saw, he always had a good experience.”

The Heart Investigation Clinic is one of five services within a cardiology program that was re-imagined and re-tooled by Dr. Sven Pallie and Dr. Madhu Natarajan for the hospital opening. More space at the St. Catharines Site allowed for the addition of the Heart Investigation Unit, a state-of-the-art diagnostic cardiac catheterization service that has performed more than 17,000 cardiac catheterization services and more than 4,300 percutaneous coronary interventions to improve blood flow to the heart since launching in 2013.

From left: Registered Nurses Cindy Emery, Judy Polihronis, Amy Dooler, Lesley Stamper, Kathy Lostrarco and Julie Janzen, and MRI Technologist Liz Staten make up some of the care team in the Heart Investigation Unit. The heart on the wall behind them is made up of smaller hearts, each one representing a patient who has been positively impacted by the Niagara Health Heart Investigation Unit. 

Prior to the opening of the St. Catharines Site, there was no dedicated coronary care unit, which treats patients requiring more intensive care. The Heart Function Unit, inpatient telemetry unit and the Cardiac Health and Rehabilitation Program round out the cardiology services.

The team of cardiologists at Niagara Health also grew from three to 12, providing care and conducting prolific research that will benefit patients locally and beyond. There are as many as 10 research projects running in Cardiac Care at any given time under Research Lead Dr. Natalie Pinilla. 

Dr. Adnan Hameed, Cardiology Head of Service, started at Niagara Health in 2011 on a temporary basis. He chose to stay permanently because of what Dr. Pallie and Dr. Natarajan were building and the exciting opportunity to help shape the program from the outset.

The Cardiology Program continues to evolve with many quality improvement initiatives underway, one involving the Heart Function Clinic to create a more multidisciplinary model of care that will include cardiologists, a pharmacist and nurse practitioners, collaborating to ensure the best care, limit re-admissions, Emergency Department visits and optimize medication therapy.

The new space, equipment and services have meant extraordinary care for patients provided by talented clinicians drawn to the innovation in cardiac care at Niagara Health, Dr. Hameed explained.

“It was the impetus to come here for people on the fence about coming to Niagara to start their career,” he says. “Since moving here, we’ve really grown a lot. With the new South Niagara Site coming, we’re in the process of determining how many more cardiologists we’ll need but we’ll definitely need more.”

Ian Fielding developed a close relationship with his cardiologist, Dr. Jeremy Adams, and the cardiac team during his five years of care at Niagara Health until his death in November 2021.

Dr. Adams, who now teaches at McMaster University’s Michael G. DeGroote School of Medicine, was getting closer to determining the cause of Ian’s heart failure, believing it to be amyloidosis, a rare disease that can cause proteins to build up in organs, impeding their function.

Through it all, Ian and his family felt confident in the care he received and the personal touch of those who looked after him. Being cared for here in Niagara also meant family could be part of the larger recovery process – something that’s difficult when patients must travel out-of-region for treatment.

“I knew who was taking care of him,” Elayn says. “It felt good knowing he was in fantastic hands. I never had to worry. I could be the daughter and not have to be the nurse. I could just sit back and have complete confidence in the staff.

“It made me proud of the program – even more proud.”