Lives at risk due to 50% drop in heart attack A&E attendances
People suffering heart attacks during the coronavirus outbreak may be putting their lives at risk by delaying seeking medical help, according to the British Heart Foundation (BHF).
New data from hospitals across England show that the number of people seen in hospital with a suspected heart attack has halved since the beginning of March. The BHF is warning that thousands of people may be at greater risk of suffering long term heart damage, needing intensive care, or even dying as a result.
The new data1 show that the number of people attending emergency departments in England with symptoms of a possible heart attack dropped from an average of around 300 per day2 at the beginning of March, to around 150 per day recorded by the end of March.
According to the BHF, this 50 per cent drop is equivalent to approximately 5000 of the expected people every month, or more than 1100 people every week, with possible heart attack symptoms not being seen in emergency departments.
In another survey of six heart attack centres in London, where the rates of Covid-19 are highest, there was an average drop of 38% in the number of emergency percutaneous coronary intervention (PCI) procedures carried out to treat heart attacks in the second half of March this year compared to the same period last year.
PCI is an emergency procedure to open the blocked coronary artery triggering a heart attack and limit damage to heart muscle.
The BHF says that across the UK this could lead to unnecessary deaths and more people living with debilitating heart failure if they do recover.
In a further BHF survey of 167 cardiologists across all regions and all nations in the UK, 84% report a decrease in numbers of patients admitted with the type of heart attack needing PCI treatment. 71% believe people are afraid to visit hospital during the Covid-19 crisis due to fear of being exposed to the virus, and 46% believe people are worried about putting pressure on an already overburdened NHS.
The BHF is urging anyone who experiences heart attack symptoms to seek medical help immediately by calling 999. Leaving a heart attack untreated can be deadly, and the risks posed by delaying reporting are much greater than those posed by the virus.
Paramedics are often able to diagnose a heart attack straight away, taking people straight to the right hospital and department where they can receive the best treatment.
A delay in people seeking medical help is one of a number of possible reasons behind the drop in emergency admissions. Breathlessness and chest pain are also known symptoms of Covid-19, potentially making it harder to identify people whose symptoms are being caused by a heart problem, and not the virus. It is also possible that changes in our behaviour caused by the pandemic are affecting these numbers.
This drop has also been seen in other countries hit hard by the Covid-19 pandemic, and more in-depth research is needed to properly understand how the Covid-19 pandemic is impacting heart and circulatory disease.
Dr Sonya Babu-Narayan, Consultant Cardiologist and Associate Medical Director at the British Heart Foundation, said:
“The coronavirus pandemic is extremely serious, but it’s concerning if it also means people’s fears about the virus are putting them off calling 999 when they suffer heart attack symptoms.
“These are uncertain times, and it’s understandable that people might feel apprehensive about having to go to hospital or putting unnecessary strain on the NHS. But heart attacks don’t stop for a global pandemic.
“Don't delay because you think hospitals are too busy - the NHS still has systems in place to treat people for heart attacks and they are still a top priority. Research has led to several effective treatments for heart attacks, but if you delay, you are more likely to suffer serious heart damage and more likely to need intensive care and to spend longer in hospital.
“You should always dial 999 immediately if your chest pain is sudden, spreads to your arms, back, neck or jaw, and feels heavy or tight, or if you become short of breath or start to feel sick.”
Dr Ramzi Khamis, Consultant Cardiologist, BHF Fellow and Co-Head of Cardiology at Hammersmith Hospital, said:
“We have seen about half as many patients as we usually do coming into our heart attack centre at Imperial, some with significant delays. We are now becoming quite anxious about the ones we are not seeing as well as the delays”.
“We want to stress that we have the staff, equipment and resources to treat heart attacks. With swift diagnosis and treatment, most people with heart attacks will recover and go on to live a healthy life. However, delays in treatment puts lives at risk, and will result in more pressure on the NHS, not less.”
Dr Nick Linker, National Clinical Director for Heart Disease, NHS England and NHS Improvement, said:
“NHS hospitals are continuing to prioritise urgent services as well as preparing and responding to the covid outbreak and so it remains important if someone has symptoms of a heart attack such as chest pain or an underlying heart problem that gets worse that they seek urgent medical attention as they normally would.
“Treating heart attacks promptly and effectively saves lives and the services to treat them are still in place for those who need them.”
For more information about heart attacks, the symptoms, and what to do, visit https://www.bhf.org.uk/informationsupport/conditions/heart-attack
For more information on coronavirus and what it means if you have heart and circulatory disease visit https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health
