Opinion: Non-COVID patients shouldn’t skip emergency room

Photo courtesy of Northside Hospital.
Photo courtesy of Northside Hospital.

As cardiologists, we have noticed a worrisome trend that is indisputable. Since mid-March, as concerns of the COVID-19 pandemic took hold, the number of patients presenting to our hospital with symptoms of heart disease or heart attacks has declined – at an alarming level.

This disturbing trend is not confined to Georgia. A new article in the Journal of the American College of Cardiology found that patients presenting with the most severe form of heart attack, called STEMI (ST-segment elevation myocardial infarction), have declined by 38 percent nationwide.

This development is perplexing because coronary artery disease is the leading cause of death in Georgia, claiming one in three lives, totaling more than 20,000 deaths annually. The number of cardiovascular deaths and patients with STEMI has remained constant over decades, prior to the COVID-19 pandemic. On average, about 1,600 to 1,700 Georgians die every month from a heart attack or from cardiovascular causes. By comparison, there were nearly 1,400 COVID-19 deaths in Georgia during the past two months. And while the pandemic is fast-moving, we also know that heart disease has not gone away. Even at its worst, COVID-19 has one-third the number of deaths compared to heart disease. As a Georgia resident, you are much more likely to die from unrecognized heart disease, than to die from COVID-19.

So the question remains: Where have all the heart attacks and heart disease patients gone?

We can speculate why patients are not seeking care for their heart symptoms. However, the more important message we want to convey, to all Georgians, is that you should not ignore heart attack symptoms.

Common symptoms include a sensation of tightness or heaviness in the chest, neck, jaw or shoulder. While we talk about “chest pain,” most patients do not describe it as pain, but more like a pressure. It is likely to be accompanied by shortness of breath, sudden dizziness and fatigue. For women, symptoms can be devoid of chest pain but instead manifest as only arm or jaw discomfort, nausea or vomiting, indigestion or simply shortness of breath and fatigue. It’s vitally important not to delay care, as seeking immediate care can save lives, improve outcomes and prevent significant damage to the heart.

We recognize many patients may be reluctant to go to the emergency room or hospital for fear of contracting a COVID-19 infection. But you should have confidence that hospitals are doing all they can to ensure your safety.

  • The entire team at Northside Hospital, where we work, is taking extra precautions, such as thorough sanitization of treatment rooms and use of personal protective equipment (PPE; e.g., masks, gowns, face shields, etc.), to protect patients and providers from the risk of exposure to COVID-19. Also, temperatures are constantly checked and masks are mandatory as each staff person or patient enters the hospital.
  • For patients with non-urgent issues, we offer virtual visits, or telemedicine, that occur over a computer connection, with live audio and video. These visits help us make an initial assessment and determine whether you need to come to the hospital.
  • When cardiovascular patients do need to come into the hospital, we use a variety of tests to make accurate diagnoses – such as stress tests, cardiac echoes, and coronary CT scans. In addition to being highly accurate, coronary CT scans minimize the amount of contact between patients and providers, while enabling us to efficiently identify patients who are at higher risk of heart attack.

These new times in which we are living require us to pay more attention than ever to our physical and emotional care. Heart disease is serious business, and if you exhibit symptoms, don’t ignore them.

Dr. Cindy Grines is chief scientific officer of Northside Hospital Cardiovascular Institute and incoming president of the Society for Cardiovascular Angiography and Interventions. Dr. J. Jeffrey Marshall is chief of Northside Hospital Cardiovascular Institute and an interventional cardiologist.