“Timely medical assistance can save life”

Dr. Farqad Alamgir is a renowned Pakistani cardiologist, who has earned a worldwide reputation in his field and has brought good name to the country.

He had been trying for some time to get the patient treated immediately in Pakistan for a heart attack, so as to save his life as well as save his heart from any major damage. He had implemented this program in Great Britain with great success.

Caretaker Chief Minister Punjab Mohsin Naqvi, recognizing the need and importance of his proposed program, has issued instructions to implement it in Punjab. In a meeting with Dr. Farqad, there was a discussion about the need and effectiveness of this program and the prevention and treatment of various heart diseases, the details of which are being presented to the readers.

Express: Why is urgent angioplasty necessary after a heart attack?

Dr. Farqad Alamgir: Heart attack is a very serious disease. One is heart pain i.e. angina, it is not such a serious matter. In a heart attack, a blood vessel is blocked by a clot, the best treatment is to perform angioplasty at the same time and open the artery with a balloon, stent, and allow blood to flow.

This is called primary PCI or primary angioplasty. Here patients were still being treated stereotypically after a heart attack. I have seen that there are so many big hospitals in the country but none of them are operating immediately except for one and a half places. They just used to inoculate, without doing anything else, which caused irreparable damage to people’s hearts.

Injections help only 30 percent of patients, angioplasty helps 100 percent. The previous government did not listen to us, I also gave presentations to them. He said to Mohsin Naqvi that you have come for some time, do this good work, it saves people’s lives.

Express: What is your proposed program?

Dr. Farqad Alamgir: I also started this program in the UK to treat the patient within 90 minutes of a heart attack. If there is no major medical facility within two hours, the patient should be immediately inoculated and transferred to a major medical facility within 12 hours for angioplasty, known as a drip-and-shift. On our presentation, Chief Minister Mohsin Naqvi issued instructions to implement it in the entire Punjab within 48 to 72 hours. He called a meeting of cardiologists of the province and implemented it immediately.

In all the big hospitals in Punjab where angiography facility is available, angioplasty is now done immediately after a heart attack instead of injection.

Whether day or night, the lab is open for Angioplasty round the clock. We know the name and data of the doctors and the data is coming to us on a daily basis. We are also getting the support of the private sector as the main objective is the benefit of the patient, and there is no longer an issue of reimbursement due to the health card. By the way, all these treatments are free in government hospitals, because when there is a heart attack, no one is walking around with four to five lakh rupees in their pocket for an operation.

However, the majority of the country’s population lives in small towns and villages, such as Chunian, Kasur, Jhang, Chiniot, Sheikhupura, etc. Heart attacks also happen there and they are not immediately available for angioplasty.

The policy for these areas is to vaccinate them immediately at local health centers and shift them to a larger health center within 12 hours. If the facility is available in a private hospital nearby, the patient will be taken there and treated.

Express: What difficulties did you face in the implementation of the program?

Dr. Farqad Alamgir: The infrastructure for the treatment of heart diseases was there in the province, there are good hospitals at the division level and in big cities. Now we have started training doctors and we are getting daily data. Availability of doctors is also a problem.

Heart attacks usually occur at night or in the morning, we have tried to operate the patient immediately during these times as well. Medical personnel have been encouraged. When it was started in Britain, doctors were given different intensives to operate immediately after a heart attack. Where angioplasty is not possible within two hours, the drip-and-shift policy is to transfer the patient to a larger center within 12 hours after the injection, so that treatment can also be started sooner.

Express: Still satisfied with the results of the program?

Dr. Farqad Alamgir: We have asked hospitals across Punjab to operate immediately on a patient after a heart attack, as it involves opening the blocked artery within 90 minutes. Time is very important in this. We get its data every day, happy that this program has started and people are benefiting, we are monitoring it.

A few days ago, a case came to light that a 40-year-old man in Rahim Yar Khan came to the hospital after a heart attack at 12 o’clock at night. Should have had an angioplasty.

Delayed heart damage is the only disease in which recovery from damage is very difficult. We are trying not to let this happen, however, people are benefiting from this program. Ever since the Chief Minister’s initiative started, earlier there were 150,000 cases per day, now there are 5,000 cases, double the number. Patients are benefiting.

Express: What is the probability of survival in the first heart attack?

Dr. Farqad Alamgir: The major heart attack that I am talking about, which is medically called ST-elevation myocardial infarction (STEMI), is diagnosed by ECG. It happens, because there is definitely a change in the ECG.

Even if there is no pain. If you do not treat a major heart attack right away, the mortality rate is very high, because then the disease becomes complicated. Well, there is a small risk factor in the treatment, but the benefit is huge because people no longer have heart flares, their pulses are no longer abnormal, and they are no longer in pain. Our poor people suffer because they were not fully treated, we have tried to remove this defect.

Express: What are the major causes of heart disease?

Dr. Farqad Alamgir: There are many things that cause heart disease in Pakistan, including high sugar and cholesterol, poor diet, environmental pollution, etc. Now this disease has come in people of young age, thirty, forty, even twenty-five years old, this disease is also inherited.

‘Preventive Cardiology’ means preventing people from getting heart diseases. The current provincial health minister Prof. Javed Akram has started pre-vento cardiology, in which people who are in the early stages.

They should be treated immediately so that they don’t suffer from heart disease, but if God willing, they should be treated immediately, and we are working on this second step ourselves. Unfortunately in our country, due to lack of education and awareness, people are finding out about their heart problems very late.

Express: What are the symptoms of heart disease? What tests are useful for diagnosis?

Dr. Farqad Alamgir: Shortness of breath, chest pain and heaviness, jaw pain, back pain, etc. After age 40 you should have regular blood tests, everyone should have their cholesterol checked.

Fasting lipid profile, sugar test. Symptoms vary from person to person, some people may even have a family history of heart problems. But the sooner you see a doctor, the sooner it can be diagnosed, and a timely diagnosis can lead to better treatment.

Adopt a healthy lifestyle, walk on an empty stomach. Walking after eating is not a good habit, if you have eaten, you should walk after an hour and a half, which is considered good for the heart.

If one has a heart attack, nowadays with good treatment a person can lead a normal life, after that you have to take regular medicines, see a cardiologist once a year, control sugar, kidneys and blood pressure. All these things are very important to note.

In UK the whole health staff like nursing staff etc work hard and conscientiously, unfortunately not here. Improper use of health card is also causing damage, in this regard there is a need for reform.

World renowned cardiologist Dr. Farqad Alamgir received his primary education from St. Anthony’s High School, Lahore. He was awarded a gold medal for coming first in Aitchison College.

His father Professor Alamgir Khan was a professor of medicine at King Edward Medical College, Dr. Farqad also graduated from the same prestigious institution in 1981. After getting his initial training in cardiology from Mayo Hospital Lahore, he went to America and then to UK. He received his MRCP degree and specialized training in cardiac surgery from the Royal London Hospital and London Chest Hospital. He has been practicing in UK for the past four decades.

Dr. Farqad is credited with pioneering a new method (Mitraclip and Tricuspid clip procedure) in UK instead of open heart surgery to repair the affected heart valve, which was safer than the old method and then it was introduced in Europe. Taught doctors from various countries, Far East and Middle East, New Zealand. During his travels abroad, he regularly visited Pakistan to meet his parents, during which he got the opportunity to guide and train doctors in the country as well. He was named the first chairman of ‘King Faisal Cardiac Center’ in Jeddah.

He started a program in the UK to operate on heart attack victims within 90 minutes, to reduce the risk to their lives. For his services, he was awarded ‘Member of the British Empire’ (MBE) by the Queen of Great Britain, while in 2012, the Government of Pakistan awarded him the ‘Sattariya Pakistan’.

He has a very special relationship with his 96-year-old mother, who now spends two to three weeks a month in Pakistan and goes to the UK for a week to spend time with her and take care of her. On the advice of friends, he tried to provide services for heart disease patients in Pakistan as well.

He wanted that even in Pakistan, an angioplasty should be done within 90 minutes of a heart attack victim. In the previous government, he gave his suggestions to provincial health minister Yasmin Rashid, Usman Buzdar and Imran Khan, which were not implemented.

When the present Caretaker Chief Minister Punjab Mohsin Naqvi was contacted, he recognized the importance of his proposed program and decided to implement it immediately and appointed him as his special representative in the health sector. They also examine the patients.