While the world focuses on the coronavirus, a developing trend is cause of great concern: hospitals are seeing fewer patients with heart attacks.
In hospitals across the country, there has been a reduction in patients with heart attacks during March-April this year, as compared to the last three years. Speaking to our colleagues around the region, country, and even the world, we have heard reports observing up to a 70 percent reduction.
Anecdotally, it has been widely observed that during the coronavirus outbreak, when patients with a heart attack do come to the hospital, they do so much later in the course of the events, after more damage has occurred. As a consequence, they are much sicker and less likely to survive once they arrive at the hospital.
Why Are There Fewer Patients?
There is a great deal of speculation around what may be causing this decline. Stay-at-home orders have removed triggers for heart attacks and strokes like excessive eating and drinking, and abrupt periods of physical exertion. It is also possible that staying at home and complying with social distancing has led to less air pollution.
But the most probable explanation - a reluctance to come to the hospital for fear of exposure to COVID-19 - is the most dangerous as it can lead to devastating delays in care.
The Direct Effects of COVID-19 on Heart
Several case reports related to COVID-19 have suggested a mechanism of the virus by which it directly invades heart cells - a phenomenon called myocarditis. Myocarditis is identified by microscopically examining the damaged cardiac cells, which are surrounded by inflammatory cells. With damaged cardiac cells, the power of cardiac contraction attenuates, and the supply of oxygen and nutrients decreases, which further threatens the heart cells. In addition, electrophysiology of the diseased heart cells will be disturbed, which results in the rise of arrhythmia risk.
No matter the mechanism, the common result is heart cell injury, followed by circulatory failure. One cohort study, conducted at the epicentre of the virus, found that cardiac injury occurred during hospitalization in 19.7% of confirmed COVID-19 cases among a study group of 416 consecutively admitted patients. Along with other clinical reports, cardiac monitoring is regarded as essential in the treatment of COVID-19, especially those in critical situations.
Keeping Heart Disease at Bay
Lifestyle can make a big difference. Controlling cardiac risk factors such as smoking, hypertension, diabetes mellitus, and hyperlipidaemia is a must to protect the heart. Increasing the endurance and improving cardio performance via regular exercise will further strengthen the heart. Through these actions, an individual can attain health capital to combat future threats against heart health.
Paying Attention to Symptoms
It is important to understand that some lung symptoms are also similar to those of heart problems — such as shortness of breath and chest discomfort — and do not always indicate COVID-19. These can indicate a serious heart problem that requires medical attention.
If a person experiences severe breathing problem, lasting chest pain or pressure, the lips or face turn bluish, or there is a feeling of confusion, it’s essential to call the doctor immediately
The Importance of Prompt Medical Attention
The need to seek medical attention immediately for a confirmed or suspected heart attack has not changed during the COVID-19 pandemic. The age-old adage “time is muscle” for heart attacks remains true today. The longer a patient waits for evaluation and treatment, the more damage occurs, and this damage is typically permanent.
Steps to Prevent Disability & Deaths from Heart Disease
Patients’ fears of becoming infected with COVID-19 on going to the hospital must be addressed. They need to be assured that the in-hospital risk of coronavirus infection has been minimised for patients being admitted with heart attacks. If you have chest pain or other heart attack symptoms – such as pain in the throat, neck, back, stomach, or shoulders that lasts for more than 15 minutes – you must call an ambulance. Remember that COVID-19 mortality is 10 times lower than that of an untreated heart attack. And rapid treatment for a heart attack works.
(Dr Rajneesh Kapoor is the Vice Chairman of Interventional Cardiology at Heart Institute, Medanta Medicity)
(At The Quint, we are answerable only to our audience. Play an active role in shaping our journalism by becoming a member. Because the truth is worth it.)