Cath labs without lifelines trigger cardiac care crisis

Srinagar, Apr 19: The successive governments in Jammu and Kashmir have flaunted new cardiac catheterisation laboratories (cath labs) as proof of improved healthcare in J&K but with absent human resource and weak ICU backups, the cath labs continue to become a pile of high-end equipment, sans a system to save lives.

During the recently concluded Assembly session, J&K government announced two new cath labs, one each in GMC Doda and GMC Baramulla, “to strengthen cardiac care in underserved regions”.

The augmentation is a much needed one given the distance of Doda or Kupwara or other areas from Srinagar, where cath labs function to some extent.

However, a closer look reveals a distressing pattern.

The shiny machines installed with fanfare are crippled by chronic staff shortages of cardiologists, cath lab technicians, nurses, no or minimal ICU backups, and fragmented referrals.

In addition, there is no clear policy on who performs what procedure where.

Many a times, the patients end up wasting precious time in seeking care at hospitals that have limited cath lab hours due to the constraints cited earlier.

The fact that a cath lab is not just equipment but a 24/7 system of trained cardiologists, dedicated paramedical staff, post-procedure intensive care, and streamlined protocols appears to be missing from healthcare planning in J&K.

As a result, this system remains largely unbuilt in J&K.

GMC Anantnag commissioned its cath lab in April 2025, the first among the new medical colleges here.

The robust lab, is running on staff that is inadequate, and nearly all of them on deputation.

The Cardiology Department at GMC Anantnag has performed over 3000 procedures, including primary angioplasties.

The cath-lab-specific technicians and nursing staff operate within this same adhoc framework.

There is no official take on this chronic issue, no discussions.

It is like, let it run as long it is running, said one specialist from the medical college.

“Since 2019, when the district hospital was elevated to GMC, no fresh construction has taken place, new buildings A, B, and C all were constructed when it was a district hospital. Only GMC college was constructed at Dialgam,” he said.

Moreover, the cath lab is space constrained, and makes procedures difficult, he said.

At SMHS Hospital, Srinagar, the only cath lab in Kashmir’s busiest emergency hospital lies defunct.

This hospital handles nearly 5000 patients daily, many of them cardiac emergencies. When a cath lab was opened at the nearby Super Specialty Hospital, it was hailed by stakeholders as “two is better than one”. However, soon after, instead of replacing the old cath lab at SMHS Hospital, it was shut.

The reason: the staff of cardiology, the trained cardiologists and the trained cath lab technicians came in a limited number, the number that was not enough to sustain even one cath lab.

Heart-attack victims and patients with life threatening cardiac conditions travel hundreds of miles to report at emergency of SMHS Hospital.

The Super Specialty Hospital has no emergency.

And then, after evaluation at SMHS Hospital, they are further transferred by ambulance to the adjacent SSH Srinagar for any interventional procedure.

Time, in heart attacks, is muscle.

Heart muscle is lost inside the hospitals with a poor system, doctors believe.

At GMC Baramulla, north Kashmir’s main tertiary centre there are widespread vacancies across departments.

There is no MRI or cath-lab capacity at theis medical college or it’s associated hospital. And with no reprieve in the human resource deficiencies, the demand of cath lab must, at best be ignored.

“We do not want equotmnet with no one to run it,” said a doctor at this facility.

Till then, he said, the cardiac emergencies from Baramulla, Kupwara, and Bandipora will continue to be shot towards the overburdened Srinagar facilities.

There are no publicly available J&K-specific guidelines on which cardiac procedures should be performed at which centre, by whom, or under what referral protocols. Globally, the experience of a cardiologist is taken into consideration while permitting him or her to carry out procedures.

Primary PCI, complex interventions, pacemakers must be safeguarded by institutionalizing these procedures.

Patients are often shuttled between facilities with ambiguous pathways, adding to the risk to their lives.

Health and Medical Education Minister SakeenaItoo acknowledged the crisis in healthcare delivery.

She said that all GMC Hospitals, including SMHS Hospital, would eventually get functional cath labs and that separate funds were being considered.

However, health activists and experts argue that announcing machines without simultaneously recruiting and retaining permanent faculty, cath-lab technologists, cardiac nurses, and dedicated ICU and HDU beds is a hollow step towards improving healthcare delivery.