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

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April 29, 2020

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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 troubled by the trend because it likely means a large number of patients who need critical 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-19 pandemic, host Jonathan Fialkow, M.D., deputy medical director, chief of cardiology and a certified lipid specialist at Miami Cardiac & Vascular Institute, talks with colleague Marcus E. St. John, M.D., interventional cardiologist at the Institute and medical director of the Cardiac Catheterization Lab at Baptist Hospital, about the reasons behind this trend and why patients shouldn’t ignore their symptoms.

You can access Baptist HealthTalk on your computer or smartphone, or via Apple Podcasts and Google Podcasts.

Dr. Fialkow: In an informal Twitter poll of interventional cardiologists, most of the respondents noted 40 to 60 percent reductions in the number of patients presenting with acute heart attacks since the pandemic. What has your experience 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 here at Baptist that have been seen elsewhere around the country, specifically for heart attacks that require treatment immediately by being taken to the cath lab. That volume has decreased by about 50%. There is not any credible reason why 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 heart attacks 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 all levels of government to stay home and avoid crowded situations. I think people are translating that into being very afraid of calling an ambulance and very afraid of coming to a hospital. But if you’re having symptoms that could be a heart attack, you have to call for help because ignoring it could be deadly. In New York, EMS services have documented an increase in the numbers of calls they’re getting to homes where people have died suddenly. A large proportion of those are probably what we call sudden cardiac death where someone had a heart attack, ignored the symptoms, and then simply died at home.

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

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

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

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

For the full podcast, you can access Baptist HealthTalk on your computer or smartphone, or via Apple Podcasts and Google Podcasts.

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