Doctors Blame Fear of COVID-19 for Sharp Decrease in Heart Attack and Stroke Cases at Hospital ERs

Since the start of the COVID-19 pandemic, doctors across the country have reported a significant drop in the number of patients they’re treating for heart attacks, strokes and other acute illnesses.

Cardiologists at Miami Cardiac & Vascular Institute, part of Baptist Health South Florida, say the number of cardiac and stroke cases treated there has declined as much as 40 percent since February and more than 50 percent over the same time last year.

While this may seem like good news, doctors are troubledby the trend because it likely means a large number of patients who needcritical care are avoiding going to the hospital, often with tragic results.

Jonathan Fialkow, M.D.
Jonathan Fialkow, M.D., deputy medical director and chief of cardiology, Miami Cardiac & Vascular Institute

In the latest Baptist HealthTalk podcast on the COVID-19pandemic, host JonathanFialkow, M.D., deputymedical director, chief of cardiology and a certified lipid specialist at MiamiCardiac & Vascular Institute, talks with colleague MarcusE. St. John, M.D., interventional cardiologist atthe Institute and medical director of the Cardiac Catheterization Lab at BaptistHospital, about the reasons behind this trend and why patients shouldn’t ignoretheir symptoms.

Youcan accessBaptist HealthTalk on your computer or smartphone, or via ApplePodcasts and GooglePodcasts.

Dr. Fialkow: In an informal Twitter poll of interventional cardiologists, mostof the respondents noted 40 to 60 percent reductions in the number of patientspresenting with acute heart attacks since the pandemic. What has yourexperience been at Baptist Hospital?

Marcus St. John, M.D.
Marcus E. St. John, M.D., interventional cardiologist, Miami Cardiac & Vascular Institute, medical director, Cardiac Catheterization Lab, Baptist Hospital

Dr. St. John: We have seen similar trends hereat Baptist that have been seen elsewhere around the country, specifically forheart attacks that require treatment immediately by being taken to the cathlab. That volume has decreased by about 50%. There is not any credible reasonwhy the COVID-19 virus should decrease the risk for heart attack – in fact,quite the opposite.

Dr. Fialkow: Why do you think we’re not seeing this preponderance of heartattacks and strokes that we did prior to COVID-19?

Dr. St. John: I think, John, the reality is,people are afraid. They’re being given these very strong messages from alllevels of government to stay home and avoid crowded situations. I think peopleare translating that into being very afraid of calling an ambulance and veryafraid of coming to a hospital. But if you’re having symptoms that could be aheart attack, you have to call for help because ignoring it could be deadly. InNew York, EMS services have documented an increase in the numbers of callsthey’re getting to homes where people have died suddenly. A large proportion ofthose are probably what we call sudden cardiac death where someone had a heartattack, ignored the symptoms, and then simply died at home.

Dr. Fialkow: How can you reassure someone who might be having a heart attack, astroke or some other non-COVID-19 emergency that it’s safe for them to come tothe emergency room? What precautions are being taken at Baptist?

Dr. St. John: People need to know that it’ssafe to come to the hospital. We’re not going to mix you in with people who mightput you at infectious risk – we’ve gone to great lengths to separate patientsby risk for COVID-19 or by a diagnosis of it. We have tents and structures outsideof the emergency department where people are screened initially. Those who areat low risk can then come into the emergency department and get their usualcare. Those who are likely to have COVID-19 can be screened appropriately andsent home where appropriate or admitted to specific units sequestered from thegeneral patient population.

Dr. Fialkow: So, your advice is, don’t delay ifyou’re feeling something significant. Still call 911. Let the paramedics assessyou; they’ll take the proper precautions. Go to the hospital if necessary; theproper precautions have been made for your safety.

Dr. St. John: Yes, we’ve adapted to the times and can serve you safely. If youhave an appointment that was scheduled already, don’t assume that it’s canceledor that you shouldn’t come. Call your doctor and see what arrangements theyhave made. And certainly, if you’re having symptoms, call your doctor and he orshe will make arrangements to have you evaluated.

For the fullpodcast, you can accessBaptist HealthTalk on your computer or smartphone, or via ApplePodcasts and GooglePodcasts.

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