Heart Patients Urged Not to Avoid Care or Ignore Symptoms
As Einstein Healthcare Network cardiologists heard the news about the new coronavirus spreading in China and later in Europe, they knew it was coming here. And they thought they knew what it would mean for heart disease.
“We began preparations for this in late February, with the expectation that there were going to be dramatic increases in heart events,” says Sumeet Mainigi, MD, Chair of Cardiology at Einstein Medical Center Philadelphia.
In China and Italy, about 20% of COVID-19 hospital patients developed a new heart problem as a direct result of the virus, Dr. Mainigi notes. It’s also known that any kind of physical or mental stress can affect the heart.
But the big increase in heart patients never happened. Instead, emergency, inpatient and outpatient visits for all types of heart problems at Einstein dropped significantly from mid-March through mid-April, compared with the same period a year ago, Dr. Mainigi says.
Einstein is not alone. A recently released survey of nine major U.S. hospitals found that cases involving a standard treatment for heart attack fell 38% in March 2020, compared with an average for the previous 14 months.
Fear Keeping People Home
The reasons are unclear, Dr. Mainigi says. “I think that there’s a lot of fear and people are trying to avoid the hospital, and that’s not surprising for routine visits or less severe illnesses.”
What Dr. Mainigi and his colleagues didn’t expect was that fear would keep people away even if they had potentially dangerous heart symptoms.
“If you’re having crushing chest pain, if you’re passing out because of an irregular heartbeat, if you can’t breathe because of decompensated heart failure, you will go seek medical attention,” he says. “And that’s what we’re not seeing.”
Although there are no numbers available yet, Dr. Mainigi fears that some people who are not seeking help may be dying at home. “The unfortunate situation is that many people are more likely to die or have a serious event from heart disease that is ignored or not treated than they would from COVID.”
Heart Care Safe and Available
He wants patients to know that it’s safe to get care during the COVID-19 outbreak and that Einstein cardiologists are ready to treat them, in person or by telemedicine.
Scenes from extremely crowded New York hospitals may have left patients thinking they can’t even get access to medical care, but that’s not true, Dr. Mainigi says.
“We have doctors in every single day. They’re in the office, in the hospital, doing telemedicine visits and providing emergency care. And we have the ability to make sure that patients are safe and our staff is safe, and provide the care that they need because we can’t hold back heart disease forever.”
People who need care should call the office, he says. In many cases, they may be able to get an appointment the same day, especially for telemedicine.
Don’t Ignore Dangerous Symptoms
“So if somebody is having symptoms – and that could be anything from chest discomfort or chest pressure to jaw pain, difficulty breathing, the feeling of a racing heart or a palpitation, swelling in their legs, fainting or near fainting, all these types of symptoms – we want them to seek immediate medical attention, potentially through the emergency room if the person feels really bad,” Dr. Mainigi says
For those with true emergencies, the emergency department is available, and the volume of patients is actually down a bit, he says.
Cardiologists have noticed an uptick in the number of patients with urgent or emergency heart problems since mid-April, but the volume is still not nearly back to the level that is expected. “I believe people are still suffering at home,” Dr. Mainigi says.
Einstein soon plans to start scheduling heart procedures for those who had them canceled and others, he says. “We’re actively working towards creating a structure by which they could come in and get their procedures in a safe, coordinated fashion. We hope to be able to implement that in the next several weeks.”
“It’s a crazy, unprecedented time, and we’re here to care for the patients. We will all get through this together.”
Contact Einstein Heart and Vascular Care specialists.