Referral to IVMC (Integrated Vascular Management Clinic)
This Clinic offers urgent vascular care to the people of the Region and the Community. The goal is to identify and stratify risk, modify the risk factors, and prevent life threatening vascular events. These events include Heart attack, Stroke, Heart Failure, and Rhythm Disorders. Diagnosis, treatment and education are provided through this clinic.
The Clinics within the IVMC are:
Chest Pain Fast Track Clinic (CPFT): Eligible patients are those who have suspected or possible cardiac chest pain, but with no clear indication for immediate inpatient admission to hospital based on an emergency room assessment or clinical evaluation in another setting including Family Health Teams. Referrals are seen urgently, within 1 working day. An RN interviews, assesses, and plans the investigation in consultation with assigned vascular physician of the day or by established protocol. Each patient has an appropriate form of stress testing and other testing as required. Further treatment is determined based on the above. If there is no immediate cardiac concerns most patients will undergo workup to look for vascular disease in other systems. Patients with high risk findings at CPFT will be offered cardiac catheterization, often on the same day.
TIA Clinic:: Transient Ischemic Attack refers to temporary stroke-like symptoms lasting less than 24 hours without permanent brain damage. Due to the fact that approximately 5% of people who have a TIA will have a full completed stroke in the near future, all patients referred to the TIA Clinic receive a prompt and thorough investigation. A Registered Nurse assesses patients with a thorough medical history. Investigations including CT scan of the head, carotid doppler of the neck, an echocardiogram, Holter monitor, and appropriate blood work are arranged. Patients are instructed to return to hospital if there is any recurrence or acceleration of symptoms. Otherwise the entire workup is typically completed in 3-4 business days. Kawartha Cardiology is one of the leading centers in the province for achieving targets for on time treatment of TIA patients. The IVMC nurse summarizes all of the data and presents the clinical case and patient to the vascular physician. Throughout the process, results are reviewed by the RN and taken to the vascular physician if high-risk abnormalities are detected
In most cases patients evaluated at the TIA Clinic will go on to more detailed cardiac workup as vascular disease is a systemic disorder and we check for it in all systems.
Heart Failure Clinic: Heart Failure (CHF) is an increasing health problem in our aging society. Unfortunately, heart failure has a bed prognosis and survival rates are worse than in many forms of cancer. However, new therapies are helping improve this situation and carefully structured heart failure clinics proved a pathway to optimizing care. At KCC we have Nurse Experts who focus on this patient population and work with the vascular physicians to optimize all aspects of patient care. They also collaborate with our Nurse Experts in the Implanted Cardiac Device Clinic at KCC since many of the patients with heart failure also require defibrillators, pacemakers and cardiac resynchronization devices. Heart failure referrals typically come from the Emergency Room, at hospital discharge and Family Health Teams. New referrals are typically seen within 2 working days.
Rapid Access Clinic (RAC): Eligible patients for the Cardiac Rapid Access Clinic are those with cardiac concerns that are not consider emergencies but important to evaluate within the next 2 weeks. These patients are often complaining of fainting, near faints, racing heart, atypical chest pain, shortness of breath without evidence for heart failure, or other complaints of unclear origin. The IVMC RN contacts and triages each patient and in consultation with the cardiologist organizes appropriate investigations.
Atrial Fibrillation Clinic: This is a special version of RAC. Due to the high risk for stroke and development of early dementia in atrial fibrillation patients who are not optimally managed the nurses triage these patients on priority basis and move them to same day or next day assessment as required.
Vascular Risk Optimization Clinic (VROC): Eligible patients are those with a risk factor profile for vascular disease requiring non-urgent vascular assessment and management. Our commitment is to manage the patient, including Cardiology consultation and to report to referring MD within a six-week period. The VROC allows the IVMC to manage Vascular Health and Disease at all stages of the continuum.
Post Stroke Management Clinic: This clinic is a special version of VROC tailored to patients with completed strokes whose stay in hospital is now over and they are ready to go home for further rehabilitation. Most patients in this clinic will undergo further investigation for vascular disease in other systems as well as optimization of existing risk factors.
These clinics combine to offer the health care providers and the people of our region a varied means of timely access to cardiovascular care in the community. The level of service and expertise is reliable, innovative and greatly valued. Our nurses work closely with each patient to ensure understanding and comfort as they navigate their cardiovascular care.