Saving lives one blocked artery at a time
Guyanese cardiologist wants to provide service here By Miranda La Rose
Stabroek News
November 4, 2003

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Guyana-born Dr Alfred Sparman, an interventional cardiologist specialising in angioplasty wants to visit Guyana on a regular basis to help prevent heart attacks in patients at risk.

Dr Sparman, who is based in Barbados, told Stabroek News recently that he was “burdened” by the high incidence of heart disease in the Caribbean, especially in Guyana, because there was no cardiologist here. “When someone gets a heart attack they must be treated immediately. If not, that person will have to succumb to the disease or the process,” he said.

Dr Sparman feels that if he could detect the symptoms earlier he could intervene before patients suffer heart attacks. For the past year he has been in touch with two local doctors at least three or four times a month, but he has not been coming to Guyana. “One of my objectives is to arrange to see patients, even those who cannot afford to see a doctor. I’m trying to see, one way or the other, how we can build some type of force where we can get at least some cardiovascular care here in Guyana. I’m meeting Dr Walter Chin and Dr Gus Lee [shortly] and starting the ball rolling because they have the machines there for screening.”

The Woodlands Hospital has an echo-cardiogram machine and stress-testing machine. Results of the tests are sent to him and he replies with his comments. If a patient needs intervention, the hospital, through Dr Chin, sends them to Barbados for treatment.

He said that the major cause of death in the world today was cardiovascular diseases - whether a heart attack or a stroke. “It is a significant problem. In the developed countries more money is spent in this area of medicine because it takes more lives.”

Dr Sparman, who was born in Linden but migrated to the US at an early age, said that if he could bring a few more of his colleagues from Miami as back-up support when conducting angioplasty, together they could reduce the incidence of heart disease in the country.

The presence of a cardiologist involved in health care in Guyana could encourage travel and tourism, he suggested, since travellers like to know that if anything happens to them up-to-date medical care is in place. He added that with cardiovascular care in place “you would be surprised to see how many people in the middle class, who are now migrating would stay around.”

Asked why he did not choose Guyana to practice his skills, he said that one of the reasons he chose Barbados was because of the reliable electricity supply on the island. The angioplasty machines, which are high tech, sensitive and expensive, would not be able to withstand the frequent interruptions in power supply. He said there were other factors but he did not elaborate.

For the past two and half years to three years, Dr Sparman has been practicing in Barbados. “I’m the only surgeon practicing angioplasty. Patients come from all over the Caribbean.”

Asked about heart attacks, Dr Sparman said that as people got older their arteries would get clogged up with fatty material. There are three arteries to the heart - one to the front, one to the side and one at the back. If one gets clogged up it would decrease the blood flow to the heart and the muscle dies. A heart attack is the result. “One third of the people who get heart attacks would die even before getting medical attention.”

He added that young people were also at risk. Increased risks include high blood pressure, diabetes, high cholesterol and smoking. People with a family history of heart disease are also at risk.

He said angioplasty involves an operation conducted on the femoral artery, found in the groin, which goes to the arteries around the heart. He passes a fine tube through the groin along the artery and to the blockage, which he then removes.

He operates in St Michael’s Parish in Barbados at the Caribbean American Heart Centre “where we do from A to Z in cardiology except open heart surgery.” He said that 85-95% of the cases are clogged arteries and are fixed by angioplasty and not open heart surgery. He emphasised that “there are certain cases, such as severely blocked arteries in which angioplasty is not appropriate, that need open heart surgery.”

The procedure is expensive but cost effective. It would cost less than open heart surgery and it depends on the severity of the case. Open-heart surgery costs about US$15,000. However, he said, “the difference is that in open-heart surgery you’re put to sleep for hours. And you’re out of commission for six months. It’s a major surgery. There are more risks involved. With angioplasty, the procedure takes about one and a half hours and you go home and can go back to work in two days.”

For those who have already had a small heart attack patients would be given medicines such as aspirins or small doses of nitrates to open the arteries, since any heart attack, big or small, would affect the pumping function of the heart. “Really the source of that problem is removing that blockage. If you don’t remove it, and if the first attack doesn’t get you, then the second one will.”

Apart from the dangers, he said that after a first heart attack the quality of life for many people is altered significantly.

Walking and exercise depend on how strong the heart is. “If you get a weakened heart, things you used to do, you do no more. So it is really life saving, if you get angioplasty before anything happens.”

Many diabetes patients suffer from clogged arteries not related to the heart. Dr Sparman also noted that many people had their legs amputated because of diabetes. He said this was not necessary. “I’m a doctor not a politician. God gave me the gift to practice medicine. My field is cardiology. Before I pass away I would like to make a real impact on the way cardiovascular medicine is practiced in this country.”

Meanwhile, he has advice for everyone: keep “your pressure controlled, diabetes controlled, don’t smoke, exercise, watch your weight, keep your cholesterol down... so when there is any abnormality I can take you, fix you up and obviate all that cascade that would becoming down.”

Though he has been practicing in Barbados for almost three years, Dr Sparman, a family man with a wife and a son, has been in the news because of problems with the Barbadian immigration authorities, which are seeking to have him deported. Asked about the matter, he said he would prefer not to discuss it because the case was now in the Barbados High Court. However, he said that the case has not affected his practice, adding that he had one of the largest practices on the island. “You would find a lot of people who are jealous when you are doing well. I’m the only one doing something that stimulates a lot of jealously. You find a lot of that in small communities. I’m the only person noted and specialised in angioplasty in Barbados. We have to move away from the jealousies because there is so much heart disease around there’s enough for us for everyone to practice his skill.”

Dr Sparman obtained his training in interventional cardiology at the Jacksonville Medical Centre in Florida. He practiced in Miami for two years and one year in Tennessee before moving to Barbados almost three years ago.