Heart Care in Vietnam

Project HOPE volunteer Dr. Frank Ing, a Cardiologist from San Diego, California traveled with a small U.S. Navy medical team to work with local Cardiologists and patients at the Binh Dinh Provincial Hospital in Quy Nhon, Vietnam in August as part of the Vietnam Interventional Cardiology humanitarian mission. This is Part 1 of his diary.

Sunday Aug 13, 2011

We took a 5:30 a.m. flight to Quy Nhon early in the morning and visited Binh Dinh General Hospital. We met with the hospital director, Dr. Pham Ty and the local cardiologists where official formalities and exchanges were made in a late morning planning meeting.

In spite of some sleep deprivation, we were anxious to move forward and spent the rest of the afternoon screening patients for possible cardiac catheterizations and interventions in both coronary heart disease and congenital heart disease. Some of the patients were already pre-screened by their local cardiologists and were waiting for their catheterizations. It was impressive in how quickly the patients gathered around the clinic as soon as word got out that we arrived. The facilities were crowed and equipment sparse but adequate to obtain an accurate history and physical and an echocardiogram. We brought our own pulse oximeter to assess oxygen saturation. EKGs and CXRs were obtained as needed although it seem echocardiograms were more readily available than the more basic tests such as an EKG or CXR. Their cardiologists were quite proficient in producing diagnostic echocardiograms. We had a team comprised of both adult and pediatric specialists and screened a total of 35 patients and made preliminary plans to perform catheterizations on 17 patients of whom six had congenital heart disease that can be treated in the cath lab. Two patients had suboptimal transthoracic echocardiograms (TTE) and we planned on performing a screening transesophageal echocardiograms (TEE) prior to making any decisions about the catheterization.

Monday Aug 14, 2011
Our group was divided into two teams. The “pediatric” team returned to the clinic to perform more screenings. Most were infants and younger children with congenital heart disease. We screened 15 patients from whom three patients were selected for cardiac catheterization. One of these patients required surgical repair but needed a diagnostic catheterization to make sure he is operable. Another patient needed multiple interventions and we made plans with the local pharmaceutical representative to provide dilation balloons which were not available in the cath lab. After a quick lunch, we returned to the clinic and screened seven additional patients. Meanwhile, the adult cardiology team performed 11 coronary catheterizations on patients selected from the previous day. These procedures were performed side by side with the local interventionist and cath lab staff. The “bedside” discussions and collaboration was mutually beneficial. In the afternoon, 25 adult patients were screened by the “adult” team. It was a long and hectic day but we all felt progress was made not only in the area of patient care but also in building relationships with the local physicians, staff and administrators. We all settled in for the night after a satisfying dinner at the hotel. The next day was going to be a “marathon” cath day!

Check back Tuesday for Part 2.