New Study Reminds Patients: Don't Delay Care

We're frequently reminded of the steps to stay safe during the COVID-19 pandemic: wear a mask, wash your hands, and maintain a distance of at least six feet in public spaces.
Doctors have another vital reminder to share with their patients during the pandemic: Don't delay care. Contact your doctor or go to the emergency room if you have chest pain or any signs of a cardiac problem, and don't avoid necessary medical treatments or procedures.

"The risks of delaying treatment for heart conditions can be very serious," says Rishi Wadhera, MD, MPP, MPhil, a cardiologist, and researcher in the Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology at BIDMC. Dr. Wadhera recently published a study in the January 2021 Journal of the American College of Cardiology suggesting that individuals with cardiovascular disease may not have gotten needed treatment during the initial phase of the pandemic last spring.

"We found that in several regions of the U.S. that were hard hit by the pandemic, deaths caused by ischemic heart disease (related to narrowing of the arteries) and hypertensive heart disease (related to high blood pressure) increased significantly between mid-March and June 2020, compared with the same time period in 2019,” says Wadhera. “Many clinicians’ worried that patients with urgent heart conditions were not coming into the hospital for necessary care during the first surge of the pandemic – our findings support these concerns.”

BIDMC patient Valerie Solimini had a choice to make a few months ago. Doctors told her that it was time to have her heart's aortic valve replaced before there was further damage. Should she wait?
She knew that the valve had been growing narrower, putting undue strain on her heart. The condition, known as aortic stenosis, often leads to breathlessness and fatigue. The narrowing prevents the valve from opening fully, which reduces blood flow from the heart into the body and can lead to heart failure.

She admits that she was petrified but went ahead with the procedure which was performed in the BIDMC Structural Heart Center. "My children couldn't be at the hospital because of COVID-19 restrictions, which was upsetting to me. But all of the doctors, nurses, and staff were so attentive and caring." Today she says she is not only free of worry but feels physically better than she has in years.

"Emergency physicians are hearing from patients that they are afraid to come to the hospital because they worry about getting infected with COVID-19 or because they think that during a public health emergency, their problems are not serious enough to need attention," says Laura Burke, MD, of BIDMC's Emergency Medicine Department. "The problem is that it can be hard for patients to know what is a true emergency. My colleagues and I have all witnessed patients who waited too long to be treated for heart attacks and other serious problems - this is another heart-breaking consequence of this terrible pandemic."

Although the direct toll of COVID-19 has been devastating, it appears that the virus has also taken an indirect toll on patients with cardiovascular disease, adds Wadhera. "We want to be sure patients know that it’s important for them to continue to seek and receive medical care, particularly if they are experiencing concerning symptoms, and that hospitals are very safe environments during this time."