Coronavirus: 50 per cent drop in heart attack patients attending hospital © Getty Images

Heart attack patients ‘collateral damage’ of coronavirus pandemic

A survey of hospital physicians and nurses has revealed a 50 per cent drop in heart attack patients attending hospital during the pandemic.

The number of heart attack patients seeking urgent hospital care has dropped by more than 50 per cent during the coronavirus outbreak, new research suggests.

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In the most severe heart attacks, known as ST-elevation myocardial infarctions (STEMIs), a major artery to the heart becomes blocked. Urgent treatment restores blood flow, saves lives and prevents disability, while delay causes irreversible damage to the heart muscle and increases the risk of heart failure and death.

According to a global survey by the European Society of Cardiology (ESC) the majority of hospital physicians and nurses reported a drop in the number of patients with these severe heart attacks going to hospital, compared with before the COVID-19 crisis.

On average there was a 50 per cent decrease, the findings, published in European Heart Journal – Quality of Care and Clinical Outcomes, suggest.

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They also found that, on average, 48 per cent arrived later than usual and beyond the optimal window for urgent treatment.

ESC president Professor Barbara Casadei, said: “This is the strongest evidence yet of the collateral damage caused by the pandemic. Fear of catching the coronavirus means even people in the midst of a life-threatening heart attack are too afraid to go to hospital for life-saving treatment.

“There has been a lack of public reassurance that every effort has been made to provide clean hospital areas for non-COVID-19 patients. Yet the risk of dying of a heart attack is much greater than that of dying of COVID-19.

“Moreover, cardiac death is largely preventable if patients with a heart attack come to hospital in time to get treatment. What we are witnessing is an unnecessary loss of life. Our priority must be to stop this from happening. We must continue to save the lives we know how to save.”

The ESC survey of 3,101 healthcare professionals in 141 countries was conducted in mid-April.

A separate survey of interventional cardiologists, doctors who insert stents to open blocked arteries, found a 28 per cent increase in life-threatening complications among patients with heart attacks during the pandemic.

This poll, conducted by the European Association of Percutaneous Cardiovascular Interventions (EAPCI), a chapter of the ESC, surveyed more than 600 interventional cardiologists from 84 countries during the first two weeks of April.

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EAPCI president-elect, Professor Dariusz Dudek, said: “The delays we are seeing in heart attack patients coming to hospital have significant harmful consequences.

“Patients who do not present promptly are in a far worse condition when they finally arrive at hospital, and they are often too late to benefit from the life-saving treatment that we can provide.

“Don’t delay if you have heart attack symptoms, call emergency. Every minute counts.”

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Professor Casadei added: “Patients’ fears of becoming infected by going to hospital must be addressed. They need to be assured that the in-hospital risk of coronavirus infection has been minimised for patients being admitted with heart attacks or strokes.”

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.

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