Your Heart is Still a Pandemic Priority: ESC Campaign Raises Concern Over Fewer Heart Attack Patients Seeking Care in Pandemic
By Dr. Ilka Neumann
One thing our ongoing global pandemic hasn’t put on hold is the need to act early when providing emergency cardiovascular care. Heart attacks and strokes are still happening, even as it feels the world around us has slowed down. Heart researchers have spotted a few worrying trends in the last year when it comes to patients seeking emergency care after a heart attack or stroke. As medical doctors, that’s why it’s important for us to stress that seeking care as soon as possible during a cardiovascular emergency is crucial. Furthermore, providing care is still a top priority for us as physicians. When it comes to cardiovascular events like heart attacks and strokes, every minute counts.
Are Patients Scared to Report Their Symptoms?
Campaigns like the European Society of Cardiology’s Can’t Pause a Heart deserve our support given concerning data about emergency room visits for cardiovascular care. An extensive ESC survey of hospital professionals in 141 countries found that hospitals were admitting an average of 50 percent fewer patients for heart attacks than before the pandemic. This doesn’t mean heart attacks dropped by 50 percent, but likely means fewer patients were reporting their symptoms. This is especially so because, of those patients who did come in, survey respondents reported 48 percent had cases that were delayed beyond the optimal time window for care. The drop in hospital admissions raised alarms in the cardiology community, with doctors hypothesizing that patients were putting off going to the emergency room because they were afraid to contract COVID—19 at the hospital. These hypotheses appeared to have solid footing, when one study later found a higher incidence of “out of hospital” cardiac arrests at home.
We saw patients coming later with infarctions being a few days old, where the whole situation is worse for the patient and for us to help them adequately.
It’s a concerning trend many cardiologists started observing right from the very beginning of the pandemic. “Patients were anxious about going to the doctor even if they had [heart] symptoms,” Prof. Dr. Michael Haude, Director of the Heart and Vascular Center in Neuss, Germany told the triple-i virtual scientific meeting hosted by BIOTRONIK. “We saw patients coming later with infarctions being a few days old, where the whole situation is worse for the patient and for us to help them adequately.
The ESC teamed up with the American College of Cardiology to urge patients not to put off going to the emergency room, while the Cleveland and Mayo clinic presidents co-authored a New York Times opinion piece telling patients that hospitals were still safe to go to in emergencies.
What Should Patients Know and How Can Physicians Reassure Them?
Similarly, the goal of the ESC campaign, and those who support it, is to help assure our patients that, amidst the pandemic’s stressors, seeking emergency medical care is still safe and encouraged. Heart health still matters, and it’s important that patients head to the emergency room as soon as possible after experiencing potential symptoms of a heart attack or stroke. A patient who gets early care during a cardiovascular event is not only more likely to survive, but is also less likely to have lasting damage. Symptoms may include:
- A burning or tight sensation in the chest that may also be felt in the arm, back, stomach, throat, jaw or neck
- Sudden shortness of breath
- Sometimes nausea or severe sweating
- For stroke: weakness in face, arm or leg, along with trouble speaking
If these last for any longer than five minutes, patients are advised to call an ambulance. Hospitals around the globe have implemented hygiene measures to enable safe emergency care, even during the pandemic. These measures have only improved as we learn more about the virus and how to prevent infections.
Hospitals Are Pandemic-Prepared
“We’re better prepared. We have masks and protective equipment everywhere,” Dr. Manel Sabate, Chief of Interventional Cardiology, at the Clinic University Hospital in Barcelona told the triple-i meeting. “We have kept normal activity and have not cancelled any other necessary procedures.”
As physicians, we should bear in mind the degree of stress the pandemic has put our patients under, and do our best to reassure them that heart health is still a top priority.