COVID-19 fears possible reason for ‘dramatic drop’ in cardiac patients seeking care: doctors

TORONTO — There is mounting concern among doctors and health-care professionals that patients with serious heart problems are putting off critical hospital visits or treatment because they’re afraid of contracting the coronavirus.

Dr. Andrew Krahn, the president of the Canadian Cardiovascular Society (CCS), told CTVNews.ca on Wednesday that this concern has been on the minds of cardiologists across the country for several weeks.

Until recently, the concern has been largely overshadowed by more urgent day-to-day medical needs and news regarding the COVID-19 pandemic.

While it’s true that Canadian hospitals started cancelling elective surgeries out of an abundance of caution as early as mid-March, Krahn said that doesn’t explain the 50 to 60 per cent decrease in the number of patients who would normally be visiting hospitals and clinics with cardiac issues.

“We’re used to seeing ebbs and flows in the area of 10 per cent with heart attack cases. So this is a dramatic drop,” Krahn said during a phone interview with CTVNews.ca from Vancouver.

“The heart attacks are still happening, but patients are not coming forward,” he added.

A Calgary cardiologist shared a story on Twitter about a patient and the serious consequences this can have.

“I lost the battle to save a patient last night because they waited to [sic] long to come to the hospital,” Dr. Jeff Shaw said in the tweet on Tuesday.

“I know their [sic] is a lot of fear of hospitals now and concern about being turned away. If you are sick and need help, hospitals are safe and are ready to look after you.”

WHY THE HESITANCY?

Krahn said he and his colleagues have been contemplating a number of scenarios that might potentially explain the decline.

Krahn explains that a heart patient under COVID-19 isolation measures might have mitigated risk factors because he or she may have stopped smoking, might be better at taking their medication, are perhaps exercising more and experiencing less stress.

But Krahn is doubtful that is actually the case, given the stressful environment the pandemic has created for just about everyone around the world, he says.

Dr. Debra Isaac, a cardiologist and clinical professor of medicine at the University of Calgary, agrees with Krahn.

She believes the drop in the number of cardiac cases can be attributed to patients fearing they’ll become infected with the coronavirus, or that their case simply isn’t that urgent.

“They might be scared to come in because they think they might get infected, or they think the pandemic is the biggest priority. Heart disease is still the number one killer of Canadians. We want people to realize that cardiac patients are still the priority,” Isaac told CTVNews.ca by phone from Calgary.

“We want heart patients to know that we can keep them safe if they come to the hospital, that we can care for them and that they are still a priority,” Isaac added.

Krahn echoes that sentiment, and wants to remind cardiac patient that delaying urgent care could end up doing more harm than good.

U.S. SEEING SIMILAR TREND

The American College of Cardiology addressed the decline in a statement released Tuesday.

The address states that while hospitals across the U.S. are seeing a jump in the number of patients seeking care for COVID-19, “clinicians are reportedly seeing fewer patients going to emergency rooms for heart attack or stroke.”

“Due to fears of contracting COVID-19 or taking up space in hospitals, patients experiencing a heart attack or stroke are delaying their essential care, causing a new public health crisis,” said Dr. Martha Gulati, the editor-in-chief of CardioSmart.org.

The college is urging heart and stroke patients to seek medical attention at hospitals if it’s needed.

KNOWING THE SYMPTOMS

Recognizing the symptoms of a heart attack, like chest pain and shortness of breath, or the warning signs of a stroke, and seeking timely treatment can make a world of difference for a patient, according to Krahn.

“We have effective therapies for these condition. But they need to be given urgently, with a window of opportunity to help reduce damage and restore health,” he said.

For more information about the warning signs for either disease, you can visit the Heart and Stroke Foundation website.

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