SAN ANTONIO — Because of multiple complex factors, cardiac disease is more common among children in South Texas than elsewhere in the state.
To help address this long-standing concern, CHRISTUS Health and philanthropic partners have been making strategic investments that have expanded the breadth and quality of the pediatric cardiovascular program at CHRISTUS Children's in San Antonio. This has increased care access and improved heart health outcomes for South Texas kids, says Dr. Ravi Ashwath, who is division chief of pediatric cardiology, the Richard S. Wayne, M.D. endowed chair in pediatric cardiology at CHRISTUS Children's and a pediatrics professor at Baylor College of Medicine.
"Recognizing the critical demand for specialized heart care, CHRISTUS Children's aimed to create a comprehensive heart center that could serve as a central hub for pediatric cardiovascular services in the region," Ashwath says.
CHRISTUS Children's has made much progress toward this goal, he says, and its "strategy not only addresses immediate health needs, but also fosters long-term health and well-being for the community."
Myriad risk factors
Ashwath says South Texas children — and particularly those in marginalized communities — are at heightened risk of cardiovascular disease because of several factors. Among them:
- A high prevalence of obesity and diabetes, which are significant risk factors for heart disease.
- Health care access barriers that can lead to delayed diagnosis and treatment.
- Socioeconomic factors such as lack of access to healthy foods and safe places to exercise and play.
- Cultural and language differences that can lead to misunderstandings of medical information.
Ashwath says CHRISTUS Children's has been "actively working to address these gaps by expanding its cardiovascular services and developing comprehensive programs to serve the less privileged children in the region."
Cris Daskevich, CEO of CHRISTUS Children's and senior vice president of pediatric and maternal services for CHRISTUS Health, notes that while cardiovascular services are reimbursed by private and government insurance, the significant, multiyear capital infusion by CHRISTUS Health and the support of philanthropists have accelerated the growth and advancement of the pediatric cardiology program. She notes that CHRISTUS Health and the philanthropic community have similarly invested in CHRISTUS Children's other five pillars of excellence: the Center for Surgical Innovation, the Maternal and Fetal Care Center, the Center for Neurosciences, the Cancer Center and the Mission and Ministry division.
No others in area
CHRISTUS Health's San Antonio ministry began in 1869 with a downtown infirmary and has grown to include 10 hospitals and a network of outpatient sites around central and South Texas. The children's hospital branched off as a freestanding facility in 2012, and, in 2020, CHRISTUS Children's implemented a strategic expansion plan to respond to population growth.
The Heart Center at the Children's Hospital has grown significantly along the way, and it now offers a wide range of services, including congenital heart surgery, cardiac catheterization, electrophysiology, fetal cardiology, advanced cardiac imaging, cardiac intensive care, cardiovascular genetic testing and exercise stress testing.
Ashwath notes that beyond being the sole or one of the few providers of these pediatric services, the hospital also has invested in advanced imaging capabilities and other new technologies that no other provider in South Texas offers. This includes stress cardiac MRIs, 4D flows, fetal cardiac MRI capabilities, cardiac CTs for all ages including newborns, 3D modeling and printing, and virtual and augmented reality for various uses to diagnose and treat complex congenital heart disease. The hospital also offers full-service cardiothoracic surgery with ECMO capabilities that no other local provider offers for kids.
Ashwath notes that, in line with the CHRISTUS Health mission, this advanced care is available to anyone, regardless of ability to pay.
Just as with the other five pillars of CHRISTUS Children's, the Heart Center offers wraparound assistance, such as services from child life specialists, dieticians, occupational and physical therapists, geneticists, pharmacists, behavioral health providers and social workers.
Ashwath adds that CHRISTUS Health is continually pursuing community outreach, education and policy work to further improve access and promote better health outcomes. He notes that in this way, the Heart Center is aiming to provide holistic care that gets at the core of the problems South Texas children and their families face.
Looming challenges
Despite the progress CHRISTUS Children's has made in building out its pediatric heart program, there are persistent challenges.
One is a critical shortage of pediatric cardiologists and subspecialists in South Texas that leads to long wait times and care delays for children, especially kids with complex conditions. Also, for many families there are disparities such as lack of insurance, transportation and other basics that interfere with their ability to get pediatric care. Also, there is a gap in prevention and early intervention around obesity and diabetes, conditions closely related to cardiovascular health. There is also a need for better care coordination around pediatric services as well as for more community outreach and education.
Ashwath says CHRISTUS Health is mindful of these needs as it continues to develop its pediatric cardiology program.
"Overcoming these challenges will enable us to provide consistent, high-level care for this fragile and vulnerable population," Ashwath says. "Ultimately, our goal is to improve health outcomes, set new standards for pediatric cardiovascular care and positively impact the lives of children and their families in South Texas."
CHRISTUS Children's maintains a blog detailing how individual kids' lives have been drastically improved by the care they've received.