The only hospital in American Samoa remains without a cardiologist.
The LBJ Medical Center said it was expensive for the hospital to recruit a cardiologist and acquire the equipment needed.
Its medical director, Dr Iotamo Saleapaga, told senators it was cheaper for the hospital to send a patient off-island for care.
He said if there was a cardiologist willing to come to American Samoa, it would most likely be a retired physician whose salary would be about $US200,000 a year.
American Samoa's LBJ Hospital has opened a chronic kidney disease clinic as it tries to reduce the high rate of the disease and diabetes in the territory.
American Samoa has informed a US congressional panel that the territory is exploring building a new hospital.
There are delays for some patients needing scans at American Samoa's LBJ Hospital with a partial withdrawal of labour by the clinic.
A team of orthopedic surgeons from Australia is conducting clinics and performing surgeries for local residents with bone problems.
American Samoa's LBJ Hospital does not have enough locals who want to become nurses and has been forced to hire off island.
for ad-free news and current affairs
