A week in my heart clinics: ‘Being a voice for heart and stroke patients is at the heart of our work’
Dr Angie Brown is a consultant cardiologist and the medical director of the Irish Heart Foundation
Dr Angie Brown, cardiologist and medical director of the Irish Heart Foundation. Photograph: Eric Luke
Each week varies a great deal but my day usually starts at 8am and can finish quite late depending on my schedule. I work at the Hermitage Medical Clinic, Bon Secours and the Beacon Hospital, all in Dublin. I have some fixed sessions, which include an outpatient clinic on Monday afternoons. I’m usually in the cardiac catheterisation lab on Monday and Thursday mornings from 8am but if there are urgent cases I get slots in the lab at other times.
On Tuesday mornings I often have another outpatient clinic and on Wednesdays I do a dobutamine stress echo and transoesophageal echo list, which starts at 8.30am. Sometimes we have a multidisciplinary meeting before this, at which surgeons and cardiologists gather to discuss complex cases.
Between the fixed sessions there are daily ward rounds to review inpatients, and consultations on patients under other specialists who have cardiac problems such as high blood pressure, angina or rhythm disorders such as atrial fibrillation.
Reporting cardiac investigations such as echocardiograms, exercise tests and heart monitors takes up a lot of time and if there are any abnormalities it’s important to ensure the referring doctor gets the report rapidly, as occasionally we may need to contact the patient directly and arrange urgent investigations and review.
As medical director of the Irish Heart Foundation (IHF), my role varies from the provision of medical expertise to support the foundation’s work, and acting as a key advocate and spokeswoman on cardiovascular issues.
Advocating on behalf of heart and stroke patients, and being a voice for people, is at the heart of the work of the IHF, and recently I joined colleagues to meet Minister for Health Leo Varadkar.
We discussed a range of issues including stroke and cardiac rehabilitation services, childhood obesity and food poverty, which we believe require urgent Government action. For example, research for the IHF has proved that 3,000 stroke survivors every year would benefit from community rehabilitation services, which would actually save the State millions of euro by reducing their hospital stay significantly.
Fighting heart disease
My role as medical director is very much hands-on and I am in regular if not daily contact with colleagues there. As you would expect of an organisation in the business of fighting heart disease and stroke – which is the nation’s number one cause of death – our work often has a medical imperative, and so I attend fortnightly meetings with the management team to discuss issues around the disease, the health system, awareness campaigns and our own work and services.
But every week is different and there is never a dull moment. I am a spokeswoman for World Stroke Day and so I advise about the importance of regular blood pressure checks. I am supporting the Pumped programme in schools, promoting key health messages to children, and I also advise on the need for pulse checks as a way to detect the often silent heart condition, atrial fibrillation.
One of my passions is CPR education for the prevention of sudden cardiac death which, sadly, claims 5,000 lives annually in Ireland.
Anyone can do this lifesaving skill and last month we marked the international Restart a Heart day for the first time with a fun video showing the public how to do hands-only CPR.
To show how easy it is to perform this lifesaving skill, I was interviewed on Newstalk Breakfast and a colleague gave a quick demo of CPR live on air.
My other vying passion is research. It has long been a key focus of the IHF, which is in fact the largest voluntary funder of cardiovascular disease in Ireland. I also consider applications for stroke-prevention bursaries.
Often, research funding is geared towards large academic institutions and I love that these bursaries promote original innovative work in the area of cardiovascular disease, which is not easily funded by other sources. It is particularly geared towards young researchers with bright ideas.
Naturally, dealing with a condition on as large a scale as cardiovascular disease I also work closely with the IHF voluntary medical councils, such as the councils on blood pressure, cardiovascular disease prevention, sudden cardiac death and heart failure. These meetings are usually held early in the morning or in the evening to facilitate everyone’s day job.
Another part of my role with the IHF is teaching: for example, we run several risk-assessment training courses for pharmacists throughout the year to encourage community risk assessment while maintaining the IHF high standard of care and helping implementation of the European CVD prevention guidelines.
The most difficult part of my job is giving bad news. We are trained to keep people alive, and there is so much that modern medicine can achieve, it’s very hard to accept when there is nothing further we can do for somebody, and so my priority at these times is to help people die in comfort and with dignity.
The most frustrating part of the job is the ever-increasing mountain of paperwork. I love technology, the convenience it offers and how speedy it is. But despite this, I have as much paperwork as ever.
On the other hand, the best part is making a difference to people’s quality of life, whether that’s on an individual basis by relieving someone’s symptoms of pain or breathlessness, or on a wider scale with a successful advocacy campaign such as the IHF Stroke Action campaign.
That campaign launched Ireland’s first national Stroke Audit of services in Ireland in 2008, which was followed by Ireland’s first national FAST stroke symptom awareness campaign, all of which ultimately drove demand for stroke units around the country and made life better for patients. That is very satisfying and part of which makes my role so rewarding.
Happy Heart Weekend runs from Thursday until Saturday. See irishheart.ie
Out of hours
On days off I generally never lie in because it’s good to have the whole day to do things. At the weekend I try to get a couple of horserides in. Some days we are lucky with glorious sun and we can have a good gallop, which is guaranteed to blow away the cobwebs and clear the head of the week’s worries.
A couple of long walks with the dogs over the bogs or beside Lough Ree is another wonderful way to unwind, and of course my husband, Ray, and I enjoy meeting up with good friends for a concert or for dinner, a chat and a glass of wine.