Data from Statistics Canada and the Canadian Institute of Health Information point to the Miramichi as a leader in heart disease. The area serviced by the Miramichi Regional Health Authority has the highest rate of heart attacks and stroke per 1,000 population in the province of New Brunswick.

The majority of admissions to the Critical Care (CCU) and 2 West Medical/Stepdown Units of the Miramichi Regional Hospital are related to cardiac illness. In 2002, an average of 52 patients per month were admitted with myocardial infarction or heart attack, angina, and stroke. This number does not include other cardiac conditions such as high blood pressure.

Becky Steeves, Manager of CCU says in 2002, the Miramichi Regional Hospital referred eight patients for cardiac surgery and another 208 for cardiac catheters to the Atlantic Health Sciences Heart Centre in Saint John. "This does not include clients who required general assessments or those referred as outpatients."

She says patients presenting to the CCU with heart disease are now much younger. "In the past we would see most patients admitted in their 60s and 70s with heart disease and now we have a growing number of patients in their 30s and 40s." She says that lifestyle is the major contributor to the problem.

At the age of 53, Michael Fletcher experienced his first encounter with heart disease. "I went to the Miramichi Regional Hospital with chest pains and I ended up in Saint John where a stent was put in," says Fletcher. A stent is a stainless steel mesh tube that is used to keep coronary arteries expanded. A few months later, he had another stent put in when he experienced more problems. He says the experience made him realize he had to make some lifestyle changes and the cardiac rehabilitation program at the Miramichi Regional Hospital provided him the information he needed to move forward.

The Miramichi Regional Hospital has always provided cardiac teaching and in partnership with the Atlantic Health Sciences Heart Centre in Saint John, has standardized its education material. "The objective of the program is to help patients diagnosed with heart disease," says Bonnie Matchett, nurse manager of 2 West Medical/Stepdown unit. She says a daily census is printed in CCU and 2 West Medical/Stepdown indicating the names of patients whose diagnosis is related to heart disease. "As a result of their diagnosis, these patients are probable candidates for cardiac rehabilitation teaching."

"Early rehabilitation consists of patient education while the person is still in hospital," says Matchett. She says the hospital adopted the Heart and Stroke Foundation of Canada’s Recovery Road program to facilitate this educational component. "We have two part-time nurses who coordinate education for identified patients and nursing staff that deliver the program." The education is comprehensive and each patient is given a free book of information to take home.

"I received my education in January over a period of a few days from the nursing staff at the Miramichi Regional Hospital," says Fletcher. He says the information was beneficial as it made him think about his current lifestyle and provided him with practical solutions. "I followed the program and am now eating better, have stopped smoking, and am exercising more," says Fletcher.

"In order for patients to recover and live a productive life they must take charge of their health. It is very important for patients to take the time to examine their lifestyle risk factors and learn how to modify them," says Dr. Tom MacAvinue, Chief of Internal Medicine at the Miramichi Regional Hospital. He says risk factors that can be controlled include smoking, high blood pressure, eating a healthy diet, physical activity, cholesterol, managing stress, and diabetes.

"These are life long changes and not a short six month solution," says Fletcher. He says you have to be committed to healthy eating and active living, and make it part of your daily routine. "If you continue to abuse your body, you will pay the price."

The Health Authority will include the outpatient rehabilitation component in its three-year Health and Business Plan that will be submitted to the Minister of Health and Wellness. "This consists of a supervised outpatient exercise and education program that is to be implemented about two weeks after release from hospital, and continue for 12 weeks," says Matchett. A more advanced program is offered six to eight weeks after the event by the privately operated River Rehabilitation Services in Miramichi, and consists of an eight week supervised exercise program.

Heart Disease Facts from the Heart and Stroke Foundation of Canada

• Pain
• Sudden discomfort or pain that does not go away with rest
• Pain that may be in the chest, neck, jaw, shoulder, arms or back
• Pain that may feel like burning, squeezing, heaviness, tightness or pressure.
• In women, pain may be more vague
• Shortness of Breath – difficulty breathing
• Nausea – indigestion or vomiting
• Sweating – cool, clammy skin
• Fear – anxiety or denial

Signs may be mild or severe. If you or someone you know is having any of these signs, call 9-1-1. Early intervention in the case of a cardiac emergency can mean the difference between life and death.

• Sudden weakness, numbness or tingling in the face, arm or leg.

• Sudden temporary loss of speech or trouble understanding speech.

• Sudden loss of vision, particularly in one eye, or double vision.

• Sudden severe and unusual headache.

• Sudden loss of balance, especially with any of the above signs.

Call 9-1-1 immediately

• Your family physician
• Heart and Stroke Foundation of New Brunswick
  110 Crown Street Suite 340
  Saint John, New Brunswick E2L 2X7
  Telephone (506) 634-1620 or 1-800-663-3600
  Fax (506) 648-0098
  heart.strokemail@nb.aibn.com 
  http://www.heartandstroke.ca