- Doctors call for increased awareness on the importance of monitoring heart health in cancer care.
- SSMC’s recently launched cardio-oncology clinic is one of the few in the region to offer specialist cardiac care for oncology patients.
Abu Dhabi, United Arab Emirates: Sheikh Shakhbout Medical City (SSMC), one of the UAE’s largest hospitals for serious and complex care and a joint-venture partnership between Abu Dhabi Health Services Company (SEHA) and Mayo Clinic, is setting a new benchmark for monitoring and treating potential cardiac issues in people undergoing treatment for cancer.
Since launching at the end of 2022, SSMC’s cardio-oncology clinic has helped several patients achieve positive outcomes. Recently, a 44-year-old woman diagnosed with breast cancer was referred to SSMC’s Cardiac Intensive Care Unit (CICU) with acute heart failure decompensation and she was determined to have an ejection fraction of 15-20%. Her heart was pumping out only a minimal amount of blood with each heartbeat. According to the American Heart Association, a normal heart’s ejection fraction ranges between 50% and 70%. An ejection fraction measurement under 40% can indicate heart failure with reduced ejection fraction.
M.B. was diagnosed with stage 2 breast cancer and she received chemotherapy and radiation therapy followed by targeted therapy. Her last reported ejection fraction during chemotherapy a few months before CICU admission was 54%. Later, the patient was admitted at a hospital with an acute heart failure diagnosis, as a result of having an ejection fraction of 20%.
Chemotherapy is a highly effective treatment in destroying tumors and reducing the risk of cancer spreading, however it can affect heart ejection fraction. Explaining the need for a multidisciplinary approach, Dr. Hadi Skouri, consultant cardiologist, said that it is important for cardiologists and oncologists to collaborate when treating a person for cancer.
He explained, “One of the possible complications of chemotherapy is developing heart disease, even if the patient has a healthy heart before starting their treatment. Unfortunately, if a cardiologist is not involved from the start, emerging complications such as a low ejection fraction can be missed. As a result, by the time a patient is referred, they can be in an advanced stage of heart failure.”
The hospital’s cardiac unit, where the patient was first admitted, took care of her and initiated heart failure therapy. Her ejection fraction improved, six weeks after discharge, to 36%. Unfortunately, she struggled to take her medicine as prescribed and missed follow-up leading to her ejection fraction to deteriorate to 15% at her next check-up. At this point, she was seen again at SSMC’s cardio-oncology clinic.
In consultation with the patient’s oncologist, Dr. Skouri decided to continue pausing the patient’s chemotherapy to focus on improving her cardiac health. “We decided that it was in the patient’s best interest to improve her heart function, even if that meant temporarily stopping her cancer treatment,” he said. “This lady found it hard to remember to take her medication so we scheduled weekly follow-up sessions to help keep her on track, and closely monitor her heart symptoms. Moreover, educating the patient about her condition was of utmost importance to improve outcome and medication compliance.”
As a result of this approach, the patient’s ejection fraction reached 55% and she was able to resume her chemotherapy. The patient, who was very appreciative of the support she received during her cancer treatment, said, “I was extremely concerned about having shortness of breath, so I went to the emergency department, and thanks to Dr. Hadi and the team, and the frequent follow-ups, my heart condition has really improved.”
Dr. Aisha Alsalami, consultant medical oncologist at SSMC, agreed that sometimes heart health is unfortunately overlooked when treating patients with cancer. Commenting on another case, she said, “We recently treated a 57-year-old patient who was undergoing immunotherapy and chemotherapy for breast cancer. She had come to the hospital very short of breath and was discovered to be in acute heart failure with an ejection fraction of 15%. Her care was transferred to the cardio-oncology clinic and with close monitoring of her treatment and symptoms, her ejection fraction had improved to 57% at her last visit.”
Dr. Matthew Gettman, chief medical officer of SSMC, stressed the importance of cross-specialty collaboration. “Historically, the different specialties often worked in isolation, focusing on the immediate problem before them. For instance, an oncologist will apply his or her specialist knowledge to treat a cancer to the best of their ability, but they may not prioritize monitoring heart health with the same level of rigor. That’s why at SSMC we place very high importance on multi-disciplinary collaboration, bringing experts in their field together to care for every aspect of a patient’s health. Our new cardio-oncology clinic is a prime example of this guiding principle and is already improving outcomes for patients in the region and beyond.”
About Sheikh Shakhbout Medical City (SSMC)
Sheikh Shakhbout Medical City (SSMC) is a joint venture between Abu Dhabi Health Services Company (SEHA), the UAE’s largest healthcare network, and Mayo Clinic, a non-profit global leader in medical care, education and research headquartered in the United States of America. Established in 2019, SSMC is the largest tertiary hospital in the UAE and serves to elevate the provision of healthcare services in the nation under the mandate of the Abu Dhabi Economic Vision 2030.
Supported by the latest diagnostic and treatment modalities available, SSMC offers care in 44 specialties. A team of locally and internationally trained physicians and allied health staff work seamlessly together, which promotes comprehensive interdisciplinary learning, allowing SSMC to become a leading hub for integrated patient-centric medical services in the region.
As the region’s leading tertiary facility, SSMC has 742 patient beds, 18 operating theatres and includes a hybrid operating room, 26 neonatal intensive care units and the UAE’s largest pathology lab.
About SEHA:
The Abu Dhabi Health Services Company PJSC–SEHA – is an independent, public joint stock company created to develop the curative activities of the public healthcare system in Abu Dhabi. The company owns and operates all the public hospitals and clinics of the Emirate of Abu Dhabi.
SEHA is part of ADQ, one of the region’s largest holding companies with a broad portfolio of major enterprises spanning key sectors of Abu Dhabi’s diversified economy.
SEHA is committed to continuous improvement of customer care to recognized international standards and providing the community with world-class healthcare. SEHA operates 13 hospitals with 3,385 beds, 70 ambulatory care, family care and urgent care centers and 2 blood banks. Its facilities accommodate 117,162 inpatients annually and conduct 43,262 surgeries, as well as treating more than five million outpatients. SEHA is one of the largest integrated healthcare providers in the Middle East with more than 18,000 doctors, nurses, ancillary care, and administrative personnel. Learn more at http://www.seha.ae.
About Mayo Clinic:
Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news and Mayo Clinic Facts for more information about Mayo.
