Cardiac Care
Cardiac care turned on its head by the pandemic
First there were no cardiovascular specialists to treat patients , then patients began to avoid treatment . The pandemic has taken a toll on heart health .
One consequence was that cardiac patients started presenting with heart attacks at rates higher than usual
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COVID-19 has had a multifaceted effect on healthcare and heart disease ,” said Dr Suresh Nair , a cardiologist at Mount Elizabeth Novena Hospital in Singapore . “ We ’ ve seen a lot of very strange trends happening , and I don ’ t think this is the end of it .”
Speaking at Medical Festival Asia , an online event co-conceptualised by Global Health Asia-Pacific and Messe Düsseldorf Asia that took place last December , Dr Nair outlined how the pandemic continues to remain an unknown quantity , even a year after turning healthcare and heart medicine on its head .
During the first lockdown phase of the pandemic , healthcare workers were unaware of what to expect while their institutions desperately hunted down a playbook that had not yet been written .
Stress causes heart muscles to become weak
“ A lot of people were not getting access to healthcare ; we were told to push away everyone except for the emergency cases . We didn ’ t know how this disease was going to affect people ,” said Dr Nair .
But as the pandemic worsened , the balance quickly shifted . Whereas previously , hospitals had been placing their full attention on COVID-19 patients and reassigning their specialists in other disciplines to emergency healthcare , it was now the public who stopped seeking care unless they absolutely needed it . Doctors ’ appointments went unattended , and follow-up care was abandoned by many people .
One consequence was that cardiac patients started presenting with heart attacks at rates higher than usual . Heart health was broadly declining , leading to more serious cases of heart failure that forced patients to be intubated before they arrived at the hospital .
“ We were treating much sicker patients at that time , and at the same time , people were afraid to go to screenings because they thought that would be exposed when they entered into hospitals ,” said Dr Nair . “ It was a fear perhaps that the hospitals themselves might have posed a bigger risk to them than their conditions . A lot of them didn ’ t come in .”
Another impact of both the pandemic and lockdowns was that whole populations began to fret about their futures , economically , socially , and professionally . With stress levels soaring , people with no history of heart conditions started to develop cardiac symptoms .
It was not just Dr Nair . Cardiologists from around the world were also starting to see otherwise healthy people coming in with palpitations even though there were usually no blockages found in their patients ’ arteries and hearts were still beating strongly . Prior good health could not prevent a spate of heart attacks brought about by the stress of the pandemic .
“ There are different types of stress , such as emotional , psychological , and physical stress . We ’ ve seen patients with severe emotional stress having a condition called takotsubo cardiomyopathy ,” he said . This condition occurs when the heart muscles
52 JUNE 2021 GlobalHealthAsiaPacific . com