A new book In a Heartbeat aims to shine a light on cardiovascular disease, with the help of cardiologists including Dr Kushwin Rajamani. Heart is at the centre of this book, in more ways than one.
By Andrea Downey
Compassion, gratitude and love are all matters of the heart, so it’s especially fitting that these are cardiologist Dr Kushwin Rajamani’s main motivators.
From studying and training abroad, setting up his own clinic here in Perth, to humanitarian work, the Associate Professor can now add literature to his list of achievements after contributing to a new book about cardiovascular disease.
In a Heartbeat, by Rachel Jayne Cassidy, details in-depth stories from experts, survivors and medical professionals. The book seeks to shine a light on the experiences of those working in the field of cardiovascular disease, as well as that of patients and their loved ones.
Cardiovascular disease is a leading cause of death in Australia, claiming the lives of one in four people. On average, 120 Australians die from cardiovascular disease every day.
With such stark figures in mind, it’s a safe bet to say most of us will be affected by CVD at some point in our lives, whether that’s reflected in our own health or the health of a loved one.
Rachel penned the book after her own near-death experience. Had it not been for a chance visit from her son, Rachel – who was otherwise fit and healthy – may not have survived her heart attack.
The poignant and often inspiring stories in each chapter serve as a reminder that life is fragile and can change in a heartbeat, while championing the important work underway here in Perth, and nationally, to improve outcomes.
For Dr Rajamani – the only WA-based cardiologist featured in the book – he hopes it will spread the message of heart health to wider audiences.
“As a clinician, I can have a reach of about 10,000 patients a year, but what this book can do is reach millions of people,” he told Medical Forum.
“Being part of this book was important to me. This is the first time that a publication of this nature has come forward where you have patient and clinical perspectives in the same book, presented with valuable information from which patients can take away from.
“This is also an important resource for general practitioners and other doctors to give them an understanding of where a lot of the misconceptions of care or gaps in understanding come from in the general population, and to help identify where these gaps could be addressed both in primary care and in the cardiology space.”
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With an increase in public awareness of different cardiac conditions, Dr Rajamani is also hoping for increased patient engagement and ownership of their health.
“What we are attempting to do in this journey is increase public awareness of heart conditions. We want to engage patients holistically and also enable them to take ownership of their own heart condition,” he adds.
“The more patients understand their condition, the more likely they are to be engaged and to be compliant with medications, as well as their necessary lifestyle changes.”
A passion for rhythm
Born in Sri Lanka, Dr Rajamani did his medical degree at Ireland’s Royal College of Surgeons before moving to Australia. He completed basic and advanced physician training in cardiology at Royal Prince Alfred Hospital in 2011 and has a PhD from the University of Sydney. He also spent two years at the Cleveland Clinic in Ohio.
In 2018 he set up his practice Omni Corde, with a focus on heart rhythm disorders and atrial fibrillation. He has clinics in three Perth locations and in York.
“I’ve always loved reading ECGs since medical school and that’s one of the things that attracted me to cardiology and heart rhythm conditions.
“Atrial fibrillation is the most common heart rhythm condition we deal with. For me the physiology of arrhythmias is fascinating and what we can offer patients procedurally – because I like doing things hands on – is a major appeal.”
In the book Dr Rajamani details the enormous strides that have been made in the treatment and prevention of AF, which fuel his desire to work.
For 50 years the anticoagulant warfarin has been the mainstay in treating the clot and stroke risk associated with AF, but there are new therapies emerging.
While warfarin is effective, it requires regular assessment and blood tests to ensure levels in the body are kept at a healthy level – regulated by measuring the International Normalised Ratio.
New blood thinners, known as Novel Oral Anticoagulants (NOACs) have been available for 10 years and are not only more effective than warfarin, but do not require blood tests.
But blood thinners are only part of the picture. If medications for AF do not work, then a minimally invasive catheter ablation can be provided.
This allows cardiologists, like Dr Rajamani, to access the heart through the femoral vein. A small part of the heart is scarred using radiofrequency energy to maintain a normal heart rhythm. The surgery has a 60-90% success rate and only takes around two to three hours.
Close to the heart
It’s the impact these advancements have on patients that stick with Dr Rajamani. He recalls a patient from several years ago who woke up in the middle of the night unable to move.
“This patient was worried about her husband who was breathing erratically during sleep, but she found she couldn’t move to wake him up and then recognised that she was having a stroke,” he says.
She made it to the hospital in time and the clot was extracted successfully from her brain. At the time her heart rhythm was normal, but further testing revealed that she had AF.
The patient was started on anticoagulants and made a full recovery.
“This was a situation where a patient did not have any warning signs and, thanks to the advanced medical care, we extracted the clot in her brain and avoided long-term disability, plus detected the cause to prevent a future event.”
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In a Heartbeat is full of patient stories like this, alongside the incredible work of cardiologists, researchers and advocates across Australia.
There’s the story of Andrew, a 64-year-old fit and healthy accountant who survived a major heart attack, and the story of Greg Page, the original Yellow Wiggle, who survived ventricular fibrillation that led to cardiac arrest, among other cardiac conditions.
Then there’s the story of Arlo who was born with half a heart and had his first cardiology appointment at six days old, his first surgery at 10 days old, and went on to have numerous emergency surgeries.
While advances in research and treatment are often known within the medical community, the patient journey is always at the heart of it. Both are important, but combining the two in this book makes it more impactful.
Beyond the clinic
Dr Rajamani has grasped every opportunity afforded to him through his own hard work and dedication, but he has never lost sight of his desire to give back to the community.
His father has no formal education and can only write numbers, while his mother only went to primary school. Educating their children was a huge priority for them and gave Dr Rajamani his drive to make them proud.
It’s a drive that has given him energy to undertake humanitarian work alongside his cardiology work, regularly traveling to Sri Lanka on medical missions to to implant pacemakers in patients living in remote regions with limited medical facilities through his work with charity The Goodness Foundation.
He also fundraises for The Orangutan Project which aims to protect 100,000 hectares of Indonesia’s Leuser Ecosystem, where critically endangered orangutans, elephants, rhinos and tigers coexist in the wild.
“I like to think our role is as ‘custodians of this planet’ and my goal is to make the biggest difference possible in this short time of life,” he says.
“I feel it is my duty to give back and it’s a fulfilling journey for me to know that I have done the best I could to make the biggest difference I can in this life.
“For me the three things that drive me are gratitude, passion and love.
“Everything is seen through that, that is the fundamental driver for me. Through that I feel like I have boundless energy for my work.”
In a Heartbeat can be found online and in all major book retailers.
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