Heart Patients Should Not Delay Hospital Visits Due To Covid-19 Fears

By Dr. (Prof.) Purshotam Lal in Cardiology

Sep 4, 2020

An intriguing paradox is being observed during this pandemic that has serious implications for heart patients. Hospitals around the world including India have recorded an approximately 50% decrease in patients with acute heart attacks. Cardiologists have a varied opinion on this scenario, while some attribute pollution-free and stress-free lifestyles during the lockdown as the reason for less number of reported heart attack, others have opinioned that it may have been caused due to their inability to reach hospitals for treatment because of movement restrictions.

But, it’ is concerning that despite their deteriorating heart condition, many patients may be delaying medical attention and treatment intentionally because they are afraid of getting infected by the coronavirus. This claim can be substantiated with evidence from data of medical emergencies of Europe and the United States, where there were no such restrictions and medical help was readily available.

While patients being admitted to hospital emergency units with an acute heart attack have decreased, there is a marked increase in deaths from cardiac arrest at home. This can be probably due to the postponement and delay in seeking medical attention. Therefore, it is important to emphasize that heart patients must not ignore any symptoms and/or delay medical attention as it will further deteriorate their health.

Over the last three months, the coronavirus disease (Covid-19) has brought the world to a standstill. Most people are aware that Covid-19 affects the respiratory system, however, they are not aware that 80% of those infected only have milder symptoms which can cause fever, sore throat, cough, and body aches that abate over a couple of weeks without any treatment. Though some of these cases may get serious because of pneumonia, leading to breathlessness, requiring ventilator support, they constitute only about 20% of those infected with corona.

What needs to be brought to the people’s attention is that the Covid-19 also affects the heart in many ways and having observed this several national medical organizations including ICMR have formulated and issued the treatment protocols to manage cardiac cases during the Covid-19 pandemic.

It is now evident that patients with pre-existing heart diseases, previous heart attacks, or low-pumping efficiency of the heart (heart failure) are at a greater risk of developing serious Covid-19 infection. Those above 60 years with hypertension or diabetes have a five times greater risk of dying from it. On the other hand, even a mild coronavirus infection can lead to the worsening of previously stable heart disease, which may require urgent medical care. Therefore, heart patients must protect themselves from Covid-19 by social distancing, wearing masks, washing hands, and using sanitizers, but they should not be afraid to seek medical attention.

Heart patients also need to maintain a healthy lifestyle during the lockdown by following indoor exercise and yoga regimes, a healthy diet, sleeping, engaging in recreational activities, taking medications regularly, and above all staying positive. Going forward, these protective habits should become the new normal lifestyle.

New observations show that the virus can affect the heart in previously healthy individuals also. The virus can cause severe inflammatory responses in the body that affect the arteries and, also causes an increased tendency for clotting. This can lead to heart attacks and strokes, and people of younger age groups may not be immune to that.

The virus can also directly infect the heart muscle, causing myocarditis, which can be confused with a heart attack. This condition can lead to decreased pumping efficiency of the heart, acute heart failure, shock, heart rate, and arrhythmia and in rare instances, sudden death. This heart muscle injury is seen in 20%-30% of Covid-19 patients hospitalized with breathing problems and contributes to 50% of the deaths. Such serious patients require advanced in-hospital supportive care. Therefore, we are emphasizing again and again that in any case, patients should reach out to the hospitals for urgent care.

While we fight the coronavirus together and take care of Covid-19 patients, millions of heart patients should be reassured that their safety remains a priority for those of us in the medical profession. Experts agree that patients getting admitted now with acute cardiac problems should be tested to exclude the coronavirus. Following recovery from Covid-19, those with myocarditis may recover over weeks, but knowledge of this is limited.

Most hospitals, including Metro Group of Hospitals, provide Telemedicine consultation through which immediate advice can be sought from medical professionals. Furthermore, heart patients should feel reassured that the hospitals are open, doctors are working, and the medical facilities are safe places with well-defined protocols laid down for both elective and emergency treatment to keep the patients protected from infection.

So the clear message is: No heart patient should delay or postpone any treatment due to undue fears over Covid-19 if the need arises.

Heart patients should realize that timely treatment can save their lives