There were around 5,000 fewer hospital admissions with heart attacks in England by the end of May than would be expected, research suggests. This suggests that thousands of people missed out on potentially life-saving treatment because of the coronavirus outbreak, the study indicates.
By the end of May, admission rates had partially recovered, but remained below expected levels. The data indicates only two thirds of the expected admissions with heart attacks took place at the end of March 2020.
The study, published in The Lancet, used data regularly collected by NHS Digital from NHS Hospital Trusts in England to get up-to-date information about admissions to hospital.
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Researchers found a reduction in admissions with heart attack in England at the start of the COVID-19 pandemic by comparing weekly rates in 2020 with those observed in 2019.
According to the study, admissions with heart attacks caused by a complete blockage of an artery to part of the heart fell by nearly a quarter (23 per cent). People with this sort of heart attack are at the highest risk of suffering a cardiac arrest and usually need an urgent procedure to open the blocked artery to the heart, along with medications.
Rates of admission for heart attacks caused by a partial blockage of blood supply to the heart fell by 42 per cent, the study found. Patients with this type of heart attack need urgent assessment and treatment with medications. Many may also benefit from an urgent procedure to open a narrowed artery to the heart.
Dr Marion Mafham, clinical research fellow at the Nuffield Department of Population Health, University of Oxford – and lead author of the study, said: “Our study shows that far fewer people with heart attacks have attended hospital during this pandemic.
“It is important that anyone with chest pain calls an ambulance immediately, because every minute of delay increases the risk of dying or experiencing serious complications from a heart attack.”
The study also found an increase in the proportion of patients receiving procedures to open blocked arteries on the day of admission, and a reduction in the length of stay.
Senior author Professor Colin Baigent, director of the medical research council population health research unit at the University of Oxford, said: “Some people may still be worried about going to hospital because they fear encountering the coronavirus.
“But the truth is that, by delaying or not going to hospital, people with heart attacks are at much greater risk of dying from their heart attack than catching the virus, and the NHS is ready and able to provide excellent cardiological care.”
Researchers say there has been a similar reduction in the numbers of patients attending hospital with heart attacks, and in the numbers receiving surgery to open a blocked artery, in several other European countries, and America, during the pandemic.
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Researchers at the University of Oxford, worked with NHS Digital, in collaboration with experts from the University of Keele, the University of Leeds, Imperial College London, University College London, Barts Health NHS Trust and the Royal Brompton and Harefield NHS Foundation Trust.
Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation, said: “We’re extremely concerned about the estimated 5,000 heart attacks ‘missing’ from the UK’s hospitals throughout this pandemic. These troubling statistics point to people delaying seeking care for their heart attack, risking death or long-term heart damage.
“A&E attendances for possible heart attacks appear to have bounced back to normal levels, partly thanks to campaigns urging people to seek help if they experience symptoms. However, it’s no time to get complacent. As the threat of coronavirus appears to ebb and flow, so do people’s feelings of fear and uncertainty.
“Thanks to decades of research, prompt treatment for your heart attack could save your life, so if you think you are experiencing symptoms call 999 immediately.”
Reader Q&A: Should you give the kiss of life to someone having a heart attack?
Asked by: Dan Jones, London
When faced with someone who’s collapsed and not breathing, the best medical advice is to first call 999 and then perform CPR – cardiopulmonary resuscitation. This involves locking your fingers together and pushing down hard and fast on the casualty’s chest until paramedics arrive. But there’s controversy about combining this with mouth-to-mouth resuscitation – the ‘kiss of life’, also known as ‘rescue breaths’.
Multiple studies suggest that the added benefits aren’t worth the pause in the chest compressions, and the prospect of using it on complete strangers is thought to deter many people from doing anything at all. Nevertheless, the British Heart Foundation and the NHS both still recommend using mouth-to-mouth where possible, suggesting an alternative ‘hands-only’ CPR for those who don’t feel comfortable giving rescue breaths or who haven’t been trained.