COVID-19 may be getting most of the attention, but heart disease is still a very real concern — and so is putting off heart care due to fear of contracting coronavirus. Heart disease remains the leading cause of death for both men and women in the United States, so it is vitally important to seek medical care when you need it, especially if you think you may be having a heart attack.
In this video, San Diego Health host Susan Taylor talks with Paul Teirstein, MD, chief of interventional cardiology at Scripps Clinic and medical director of the Prebys Cardiovascular Institute, about heart disease and why it is safe to get emergency care during the pandemic.
Heart disease is most likely to affect people who have one or more of four risk factors: over the age of 60, high blood pressure, diabetes and obesity. Not only are these patients at higher risk for heart attacks and heart failure, they also have the greatest risk of serious consequences from COVID, which can affect the heart in multiple ways.
“The heart is impacted by the inflammatory response to COVID and this can cause heart failure. It can cause shock and loss of blood pressure,” says Dr. Teirstein. “Indeed, when patients with COVID are in the intensive care unit, most of the time their heart is involved in addition to their lungs, and we have patients on heart lung machines for this reason.”
Dr. Teirstein adds that patients with heart disease and COVID can get very sick, very quickly. The virus can also attack the heart directly and cause myocarditis, an inflammation of the heart muscle.
Given the severity of COVID in heart disease patients, it’s not surprising that many people with heart issues have been hesitant to come in for care. In fact, the Centers for Disease Control and Prevention (CDC) reports that visits to the emergency department for heart attacks have decreased by 23 percent due to virus concerns. However, by not getting the care they need, Dr. Teirstein says people with cardiac disease are putting themselves at even greater risk.
“This is a really big problem. We have seen patients delaying care or not coming to the emergency room and they’re having heart attacks at home, or they’re having prolonged chest pain, which is weakening their heart to the point where, when we do get to work on them, it’s a much more difficult job,” he explains.
He adds that fears of contracting the virus in a hospital or medical office are unfounded. “I want to stress how safe it is here in the hospital, or in an exam room or emergency room. Anybody suspected of COVID is isolated. Anyone who comes into the hospital is tested. Everyone is wearing masks.”
Avoiding or delaying care for a heart attack is one of the biggest concerns. Symptoms of heart attack often include a feeling of heaviness or squeezing in the chest that may radiate to the arm or jaw. In women, early signs of heart attack may include nausea, fatigue and shortness of breath.
“If you’re having symptoms of chest discomfort, especially if they last more than about three or four minutes, that’s when you want to call 911,” Dr. Teirstein says. “And if you’re significantly short of breath, come to the emergency room.”
If you aren’t experiencing symptoms but need to see your doctor for continuing heart issues, make an office appointment. Another option is arranging a telehealth visit with your doctor via video. During a video visit, you and your doctor can discuss your health and determine if you need to be seen in person or have blood tests or other lab tests done. In any case, don’t risk putting off care.