The results add credence to previous reports that found some patients feared contracting COVID-19 at the hospital and chose to delay or not seek care at all during medical emergencies last spring. As the United States continues to battle the virus and is currently in the midst of a surge of COVID-19 cases, experts say it’s imperative the public understands that care should not be delayed for vital health issues like heart problems. “If you, a loved one, or a family member are experiencing symptoms of a heart attack or stroke or any other concerning symptoms it’s really important that you seek medical attention immediately,” said study author Rishi K. Wadhera, MD, a cardiologist and researcher at the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at Beth Israel Deaconess Medical Center in Boston. “Hospitals are safe environments to receive medical care, even in the midst of this public health emergency.” RELATED: Questions About the Coronavirus Answered The team found a substantial increase in deaths from ischemic heart diseases and hypertensive diseases over that time period. Specifically, there was an 11 percent spike in deaths due to ischemic heart diseases, or those related to the narrowing of the arteries, over that time compared with the previous year. Additionally, there was a 17 percent increase in deaths from hypertensive diseases, or those related to high blood pressure. Deaths due to heart failure, cerebrovascular disease, or other diseases of the circulatory system did not change nationally over this time. Wadhera said he was surprised by how substantial the rise in cardiovascular deaths was in certain regions of the United States that were hit hardest by COVID-19 in the spring of 2020. “In New York City, for example, there was a 139 percent relative increase in heart disease deaths after the onset of the U.S. pandemic, relative to the same time period in 2019,” he says. “Other states, like New Jersey, Michigan, and Illinois, also experienced a significant increase in deaths due to heart conditions.” Massachusetts and Louisiana did not see a change in heart-related deaths over the study period. Samir Kapadia, MD, a cardiologist at the Cleveland Clinic in Ohio, says these findings are just the tip of the iceberg. “This study is well-conducted and very timely, but what this particular study cannot tell us is the kind of damage done to the heart in those who didn’t die,” he says. “In an emergency, waiting longer to come to the emergency room leads to more damage to the heart and more complications that can affect quality of life or even longevity in the future.” RELATED: What People With Heart Disease Need to Know About COVID-19
Don’t Delay Care
The reasons for the uptick in cardiovascular deaths during the onset of the COVID-19 pandemic are likely multifactorial, the researchers say. Perhaps the most concerning is that people who required emergency treatment for heart issues may have avoided care and died at home, a disturbing trend experts hope won’t repeat itself during subsequent waves. “Hospitals are extremely safe,” Dr. Kapadia says, “and compared with March and April, the good news now is that hospitals have learned how to protect patients and caregivers so that they do not get COVID-19. It is very safe and may be safer than staying at home when you have symptoms.” While signs of a heart attack can vary, the most common symptoms include chest pain that feels like pressure, squeezing, or a burning sensation that gets worse with exertion and lasts longer than 5 to 10 minutes. If you experience chest pain, along with any of the following symptoms, seek medical help immediately.
Upper body discomfort in the neck, jaw, shoulder, arms, or backShortness of breathSweatingLight-headednessNausea
While the most common symptom of a heart attack in women is chest pain, as it is with men, women are more likely to experience some of the other common symptoms, particularly nausea, shortness of breath, and back or jaw pain. Sometimes these symptoms may appear in women without any chest pain. Kapadia notes that keeping up with preventive care, including medication refills and bloodwork monitoring, during this time is also important to maintain good health and prevent medical emergencies like heart attack and stroke.
Reducing the Spread of COVID-19 Saves Lives
The study authors note other factors are likely at play, including delays in emergency medical service response times and a reduction in bystander CPR rates. A proportion of the deaths observed in the study may also have been due to the cardiovascular complications of undiagnosed COVID-19. Finally, the overall strain on the healthcare system imposed by COVID-19 may have led to delays in access to hospital care and deferral of procedural care. This is especially worrying amid the current wave of COVID-19 cases, Wadhera said. “The United States is currently in the midst of an alarming, national surge in COVID-19 cases, and we’re already hearing reports across the country of overwhelmed healthcare systems that are running out of basic supplies and experiencing shortages of healthcare workers,” he said. “These sites are turning down ambulances because they are at capacity. Hospitals are trying their best to plan, expand, and reallocate resources to deal with the surge of cases. Unfortunately, the spread of COVID-19 is exponential, while hospitals’ ability to scale-up surge capacity is not.” To prevent further loss of life he says it’s imperative everyone listen to health officials and do their part to keep COVID-19 at bay, including following social distancing guidelines, frequent hand washing, and wearing a mask. “The best strategy we can employ is to prevent healthcare system strain from occurring in the first place, by collectively adhering to basic public health measures that mitigate the spread of the virus,” Wadhera said.
