Heart Disease Doesn’t Mix Well with COVID-19

Commentary by Perrin Peacock, Co-Founder of CardioSolution

My neighbor, referring to his fear of COVID-19 exposure, should he need to go to a hospital for another health-related issue, jokingly said, “These days if I broke my arm, I’d set it myself.”

Those fears, unfortunately, are not unfounded. According to the American College of Cardiology (ACC):

“The coronavirus disease-2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 [SARS-CoV-2] that has significant implications for the cardiovascular care of patients.”

Some patients with heart disease also have other comorbidities (a simultaneous chronic disease), like diabetes for example; all of which can further weaken a patient that contracts the virus.  According to my colleague, Dr. Lou Vadlamani, an interventional cardiologist, Co-Founder and Chief Medical Officer at CardioSolution, “Patients with underlying CV disease are already somewhat weak, therefore they are at a much higher risk for adverse outcomes if they contract the virus. Nonetheless, it is critically important that neither those with pre-existing heart conditions nor those experiencing heart attack symptoms neglect them because they are afraid of contracting the virus.”

The majority of the roughly 40,000 patients we serve in 22 hospitals nationwide are over 60 years of age.  They have heart disease and are the most vulnerable to adverse outcomes if they were to contract the virus.  One of the many challenges with COVID-19 and heart disease patients is knowing which symptoms mean what.  The two diseases share multiple symptoms, such as shortness of breath and fatigue.

Across the country, procedures that are categorized as “elective” are no longer being done, as hospitals are gearing up for the “surge” in COVID-19 cases.  As a result, over the last couple of weeks, we’ve seen the procedural volume in cardiac catheterization labs declining across the country.

This is counterintuitive because the number of heart attacks should be increasing due to stress and anxiety, shouldn’t it?

Many patients are not making it to the cath lab because most cases are, unfortunately, considered elective.  Only patients presenting to the ER with a STEMI (ST elevated myocardial infarction) are making it to the cath lab.  Additionally, many hospitals are closing their outpatient clinics and cutting down on diagnostic testing during the pandemic to prevent infection. This means that patients aren’t able to see their cardiologist for routine visits and many are unable to undergo necessary screenings.

The recommended door-to-balloon time of 60 minutes may also be negatively impacted, as ensuring that healthcare workers are geared with adequate personal protective equipment (PPE) prior to moving them to the cath lab takes precious time.

In addition to the loss of critical time due to these additional protective measures, our hospital clients are also preparing to convert some beds in cardiology units to intensive care beds for virus patients.  Shutting down various units to prepare for COVID-19 and the marked decline in patients coming to the hospital for other health issues out of fear is producing a rapid decline in hospital revenue – which, unfortunately, means layoffs or furloughing of the very people we need most – nurses and other support staff.

This is not a good situation.

Medical experts universally agree that if you are over 60 with any comorbidity at all – stay home and don’t risk exposing yourselves to the virus.  However, let this be clear, that anyone experiencing heart attack symptoms during this COVID-19 outbreak should try to contact their physician immediately by whatever means necessary, then call 911 or head directly to the ER. It’s the best thing you can do given our “new normal.”

According to the Center for Disease Control and Prevention (CDC), heart disease is still the number one cause of death in the United States, with roughly 647,000 deaths annually as of 2017.  Even in the current environment, the risk of a heart attack outweighs the risk of contracting COVID-19 at the hospital.

Perrin Peacock
Co-Founder of CardioSolution