Ischaemic heart disease

Fear of COVID-19 keeping STEMI patients away from hospitals

The number of patients seeking urgent medical attention for ST-elevation myocardial infarction (STEMI) has dropped by more than half during the COVID-19 outbreak, according to global survey that includes Australian cardiac centres

A survey by the survey by the European Society of Cardiology (ESC) included reports form 37 cardiologists and cardiovascular nurses in Australia and New Zealand, most of whom (78%) said the number of people presenting to their hospital with STEMI had decreased.

More than half (58% ) of Australia/NZ respondents said the number of STEMI patient admissions had decreased by more than 40% at their institution since the start of the pandemic as compared with prepandemic.

And more than a third (36%) of cardiologists said that at least 40% of patients with STEMI were presenting beyond the optimal window for PCI or thrombolysis.

Almost all cardiology respondents in Australia (86%) said their departments had undergone restructing to  due to the pandemic to deal with the influx of patients infected with the virus. However, compared to European and US hospitals, Australian cardiology centres were seeing far fewer COVID-19 patients, with almost 80% saying it was fewer than 10 patients..

“[The] COVID-19 pandemic has impacted on the rate and timing of hospital admissions for acute coronary syndromes to an extent that would have been unimaginable just a few months ago,” the study authors concluded.

ESC President Professor Barbara Casadei said the findings were strong evidence of the collateral damage caused by the pandemic.

“Fear of catching the coronavirus means even people in the midst of a life-threatening heart attack are too afraid to go to hospital for life-saving treatment. There has been a lack of public reassurance that every effort has been made to provide clean hospital areas for non-COVID-19 patients,” she said.

“What we are witnessing is an unnecessary loss of life. Our priority must be to stop this from happening. We must continue to save the lives we know how to save.”

The findings showed that urgent action is needed to ensure patients seek help for STEMI when a second pandemic wave develops as lockdown restrictions are eased worldwide, the ESC advised.

“Medical societies, heart foundations, and governments have a responsibility to develop strategies to inform patients of the importance of seeking appropriate care, but also to ensure that a safe environment is provided for patients who are admitted to hospital because of a cardiovascular emergency. Lack of assurance on this front is likely to underpin our findings and to lead to unnecessary death and disability.”

The findings are published in European Heart Journal – Quality of Care and Clinical Outcomes.

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