Rural heart patients lack key diagnostic tools

'Every Canadian with heart failure deserves access to the best standard of care, no matter their province, region or community,’ says Senator Yonah Martin. / SENATE OF CANADA PHOTO

There is uneven care available to Canadians living with heart failure, particularly in rural and remote regions, says Senate Deputy Leader of the Opposition Yonah Martin.

“Patients in rural or remote communities often lack access to cardiologists or key diagnostic tools,” Senator Martin said during second reading debate on Bill S-204, An Act to establish a national framework on heart failure, on Nov. 18.

Citing new Heart & Stroke Foundation data, Martin said 27 per cent of hospitals don’t have access to a crucial diagnostic test for heart failure — the natriuretic peptide blood test — and 16 per cent of hospitals don’t follow published heart failure care guidelines. “This is alarming,” she said. 

Martin, who introduced the bill in May, said the consequences are clear: “Many patients are not getting guideline-recommended diagnostics or therapies simply because of where they live or where they seek care.” That means “where you live can determine the quality of care you receive and, in some cases, whether you survive.”

Martin told senators that too many patients receive diagnoses only when they arrive at emergency rooms in crisis. “Early signs, such as fatigue or mild shortness of breath, are often missed or attributed to aging or other conditions,” she said.

With no routine screening program in place, “patients often get diagnosed late, after irreversible damage has occurred,” while “four in 10 Canadians do not understand what heart failure is, and two-thirds do not know that it has no cure.”

Martin says a national strategy is needed to coordinate efforts across provinces and territories and standardize care. Bill S-204 requires that the health minister convene a national conference within 12 months of the legislation coming into force, bringing together experts, patient groups and Indigenous partners.

“In essence, a national framework is about leadership and coordination, providing the glue to bind together various efforts, fill the gaps and elevate the standard of care across Canada,” she said. Heart failure “is precisely the kind of complex, widespread health challenge that benefits from a national strategy.”

The bill outlines priority areas that include promoting early detection, improving access to guideline-directed therapies, supporting patient and caregiver education, addressing inequities in underserved communities and strengthening data collection — including the creation of a national heart-failure registry.

“Every Canadian with heart failure deserves access to the best standard of care, no matter their province, region or community,” she said.