NHCS’ COMPREHENSIVE SUITE OF HEART FAILURE SERVICES BRINGS NEW LIFE TO CHILD OF GENERATIONAL HEART DISEASE
NHCS’ Heart Failure programme offers end-to-end care services, from diagnostic tests, procedures/surgical treatments such as coronary artery bypass, implantation and management of cardiac implantable electronic devices such as pacemaker, management of advanced HF therapies such as mechanical heart assist device implantation and heart transplant, to genetic counselling and palliative care.
Singapore, 13 March 2023 – At 14 years of age, Jovan has advanced heart failure and is the youngest person in Singapore to have a HeartMate 3 left ventricular assist device (LVAD) implanted. A sporty boy who loves soccer, everything changed when his younger sister was diagnosed with cardiomyopathy – a condition with weakened heart muscle affecting the heart’s ability to pump blood around the body and is one of the causes of heart failure. Then, doctors did a scan for Jovan and discovered his heart function had weakened. He was only 10 years old when he started medications and medical follow-ups. In April 2022, Jovan’s condition took a sudden turn for the worse as he became very breathless, pale and broke into cold sweat. He was referred to the National Heart Centre Singapore (NHCS) and was implanted with a LVAD to save his life.
It was found that Jovan’s condition is genetic – his father, one of the youngest in Singapore to receive a heart transplant at the age of 19, and his 2-year old sister, have since passed away from heart failure in 2021 and 2018 respectively. His surviving grandmother has the same condition. What awaits Jovan is hopefully a heart transplant. Meanwhile, medical expenses are a challenge for his family. Besides government financial aid, the support from the NHCS Heart To Heart Fund provided the necessary financial assistance, enabling Jovan to focus on his studies, and easing the financial burden on his mother. Since his discharge, Jovan has returned to school full time and hopes to fulfill his dream of becoming a soccer player.
NHCS Heart Failure Programme offers end-to-end care services in Singapore
Heart failure (HF) is a leading cause of death1 and hospitalisation in Singapore, accounting for 17% of all cardiac admissions locally2. Despite improvements in medical therapy, re-admission rates among HF patients remains high, with about 20% to 25% having to be re-admitted within 30 days after hospitalisation3.
For those with severe and advanced HF where medications are no longer effective, they are faced with potentially deteriorating kidney and liver functions, and multiple re-admissions, resulting in very poor quality of life. Such patients, where suitable, would require a LVAD, a mechanical pump to take over the functions of the heart, as a bridge to transplant, or a destination therapy if there is no suitable heart donor.
Comprehensive disease management is key to combat the high prevalence and complexity of HF. Being the only heart and lung transplantation centre in Singapore, NHCS offers end-to-end care services through its HF programme to improve the quality of life and survival of HF patients. Comprising a multidisciplinary care team of cardiologists, surgeons, nurses, and allied health professionals, patients are cared for and supported throughout their healthcare journey, including genetic counselling for inherited cardiac conditions and palliative care. To-date, NHCS sees close to 3000 HF patients annually. Since performing the first LVAD implantation in 2009, NHCS has gone on to implant the LVAD in 135 patients, the highest number locally; and we have carried out 96 heart transplantations since 1990.
“NHCS first established the HF Programme in Singapore in 2002. Since then, we have expanded the armamentarium to provide a comprehensive suite of services to our HF patients – including diagnosis and treatment of rare forms of HF. One example is cardiac amyloidosis which is a disorder arising from abnormal proteins in the heart tissue,” shares Assoc Prof David Sim, Deputy Head and Senior Consultant, Department of Cardiology, and Director, Heart Failure Programme, NHCS.
While coping with their conditions, patients with advanced HF often have to grapple with other challenges such as financial, emotional, social and psychological well-being. As part of the HF programme, NHCS Clinical Coordinators, together with Medical Social Workers, will work closely with the patient and their caregivers to offer the necessary support they require during their health journey. In the last decade, NHCS Heart to Heart Fund has disbursed over S$2.8 million and supported close to 3,000 needy patients and those in need of novel treatment therapies.
Continuous research advances heart care in Singapore
NHCS celebrates its 25th year of pioneering heart care in Singapore, and recognises the challenges of an ageing population and increasing chronic disease burden. With the high prevalence of HF, NHCS is advancing our HF management from diagnosis and treatment, to prevention and personalisation. Studies on stem cells derived from HF patients are underway to discover new insights on the abnormalities causing HF. This can potentially help doctors test if new drugs can correct the abnormalities and target treatment for utmost benefits.
“Singaporeans’ health needs have become increasingly complex, with major risk factors for heart disease on the rise. As a national and regional heart centre, NHCS is well poised to advance the care and support for our heart patients. Besides HF, our researchers continue to deep-dive into other key areas such as Interleukin 11 (or IL11) protein responsible for cardiac fibrosis, artificial intelligence tools for better diagnosis and treatment, and cardiac ageing, to make new discoveries and bring hope to our future generation,” said Prof Terrance Chua, Chief Executive Officer, NHCS.
In conjunction with its 25th anniversary, NHCS will be holding its biennial fundraising event ‘NHCS Heart To Heart Gala’ on 17 March 2023, at The Ritz Carlton, Millenia Singapore, with the aim to raise $1 million towards providing financial assistance for needy patients, subsidising novel treatment for patients in need, as well as advancing cardiac care through research and education.
- Ministry of Health
- Chan WX, Lin W and Wong RCC. Transitional care to reduce heart failure readmission rates in South East Asia. Cardiac Failure Review 2016; 2: 85–9.
- Jencks, S. F., Williams, M. V., & Coleman, E. A. (2009). Rehospitalizations among patients in the Medicare fee-for-service program. New England Journal of Medicine, 360(14), 1418-1428. doi: 10.1056/NEJMsa0803563