Heart scans save time and money in Canada’s far north

March 2020

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An acute care facility in the Nunavut territorial capital of Iqaluit becomes the country’s most northern hospital capable of performing cardiac computed tomography.

Technologists at the Qikiqtani General Hospital (QGH) in the Nunavut territorial capital of Iqaluit are now performing sophisticated scans of patients’ hearts. It’s a feat that saves would-be travellers in the name of cardiac health the burden of a lengthy trip south for diagnostic testing, and the stress of waiting for the diagnosis.

QGH is the sole acute care facility in the Qikiqtani (Baffin Island) region. It is now believed to be the most northern hospital in the country performing cardiac computed tomography, part of a collaborative program headed by the diagnostic imaging departments of both the University of Ottawa Heart Institute (UOHI) and The Ottawa Hospital (TOH).

This is an innovative program we hope will improve patient outcomes in the future.

- Dr. Carole Dennie, UOHI

“This is an innovative program we hope will improve patient outcomes in the future,” said Dr. Carole Dennie, co-director of cardiac radiology at the UOHI. “The patients will benefit from having access to a test for heart vessel disease that is very sensitive.”

Charge Technologist Jennifer Sharpe performs Qikiqtani General Hospital’s first ever cardiac CT on January 22, 2020.
Inside the CT Suite at Qikiqtani General Hospital, Charge Technologist Jennifer Sharpe performs the hospital’s first ever cardiac CT on January 22, 2020.

That test, computed tomography scans, also called CT or CAT scans for short, uses X-ray technology to take detailed 3-D pictures of the body’s bones, blood vessels, vital tissues and organs. In 2014, QGH first started offering this imaging modality to patients, but was limited to studying the head, spine, abdomen, colon, and chest. In January of this year, the hospital secured the cardiac gating software required to conduct scans of the heart.

Cardiac CTs determine whether plaque or calcium deposits are present in a patient’s heart vessels (coronary arteries) and identify harmful blockages. Because an imaging physician can produce a comprehensive report in a matter of hours, CT scans are rising in popularity and proving to be one of the leading non-invasive tools for detecting coronary artery disease.

According to Dr. Dennie, the risk of developing early onset coronary artery disease is greater among Nunavut populations than other groups in Canada, though the reason for this is not yet understood.

Dr. Carole Dennie, Mark Hoogkamp (UOHI) and Dr. Jose Aquino pose for a picture in Iqaluit.
UOHI’s Dr. Carole Dennie (left) and Senior Clinical Coordinator Mark Hoogkamp (middle) arrive at the Iqaluit airport on January 21, 2020. Accompanying them, Dr. Jose Aquino, a staff radiologist at The Ottawa Hospital appears in the background.

Prior to 2020, patients in Iqaluit who fit the criteria for cardiac CT referral, typically those presenting in hospital with symptoms suspicious for heart vessel blockage, would make a lengthy trip to Ottawa to undergo testing at the UOHI. In these cases, patients would be accommodated in boarding homes while waiting for their exam, often staying an extra day to attend follow-up appointments before traveling home. The entire process could take as long as a week.

Today, in collaboration with UOHI and TOH, Qikiqtani General Hospital is successfully administering their own cardiac CT scans in Iqaluit. The images are transmitted to Ottawa for same-day analysis and reporting.

“A normal CT may obviate the need for further testing, which has to be performed in Ottawa,” said Dr. Dennie. “This eliminates potential harm from complications of these tests and the emotional strain of waiting for the tests to be arranged and completed in Ottawa.”

Conversely, Dr. Dennie added, “If the CT is abnormal, for example, if it shows severe blockages, further testing and treatment in Ottawa can be expedited resulting in improved patient care.”

In Ottawa, the UOHI completes a dozen cardiac CT scans each day. Imaging teams are currently averaging an additional exam per week from Iqaluit, a number Dr. Dennie estimates will soon rise as more patients learn about the program.

Mark Hoogkamp, Dr. Carole Dennie (UOHI) and Dr. Jose Aquino (TOH) pose in Iqaluit.
Mark Hoogkamp (left), Dr. Carole Dennie (middle) and Dr. Jose Aquino leave Iqaluit after successfully assisting with the first cardiac CTs ever performed on Baffin Island.

“We are expecting the volume of cardiac CT from Iqaluit to be between 50-60 per year, and we predict the volume will increase over time,” she said.

Cardiac CT scans improve the diagnosis of heart disease, help healthcare providers determine if interventions are necessary, and improve patient placement into appropriate areas of care.