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“Instructions to ‘stay at home’ and ‘don’t come to the hospital’ do not apply to patients with heart attack symptoms,” she said in a statement.
Hospitals also must have designated areas for MI patients to prevent the spread of coronavirus infections, said Casadei, also an honorary consultant cardiologist at the John Radcliffe Hospital in Oxford, England.
“Every minute counts when you have a heart attack,” she said. “If you have symptoms of COVID-19 such as a high temperature or new persistent cough, tell the emergency services in advance. But get to a hospital quickly.
“Your life matters. If you are having a heart attack, we know how to save you and can do so very rapidly and effectively.”
Disappearing STEMIs
Even before the professional societies issued their appeals, cardiologists were expressing concern about patients they are no longer seeing — but are trying to remain connected with — during the pandemic.Samreen Raza, MD, Baylor Scott and White Heart Hospital, Plano, Texas, tweeted: “As your Cardiologists, we want you to know, that we are still here for you and to take care of your heart (emoji).”
Harlan Krumholz, MD, Yale New Haven Hospital, Connecticut, detailed the “previously unimaginable” shift in demand for hospital services in a recent piece for the New York Times, citing an informal Twitter poll by @angioplastyorg, in which half of respondents reported seeing a 40% to 60% reduction in MI admissions.
A Spanish Society of Cardiology survey of 71 centers in the STEMI network also reported a 40% decrease in patients treated with percutaneous coronary intervention for STEMI and a 5% COVID-19 infection rate among interventional cardiologists during the week of March 16–22 (after the outbreak), as compared with February 24–March 1.
Just days later, a rapid research letter, published April 10 in the Journal of the American College of Cardiology, identified a 38% reduction in STEMI activations at nine high-volume US catheterization labs on March 1, as compared with the 14 months leading up to the COVID-19 pandemic.
All nine sites had more than 180 STEMI cath lab activations every month (mean 23.6 activations/month) in the period before the outbreak, but reported only 138 activations (mean 15.3 activations/month) after the outbreak.
