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Coronavirus Alert Spanish cardiologists have seen a worrying trend in recent weeks: the treatment of acute myocardial infarction has decreased significantly, coinciding with the state of alarm for the coronavirus pandemic. The exact reason for this decrease is unknown, but most likely, many people with heart attack or angina symptoms have stopped coming to health services or are long overdue for fear of becoming infected with COVID-19. The consequences can be very serious.
The obligatory confinement of the population in their homes has led to the paralysis of most activities, but essential services are maintained and cardiac emergencies continue to be attended to, as Oriol Rodríguez, cardiologist at the Germans Trias i Pujol University Hospital, assures ( Badalona, Barcelona) and member of the Interventional Cardiology Association of the Spanish Society of Cardiology (SEC). “It is important to convey an important message: in people who have a heart attack, the main prognostic variable is the time that elapses from the beginning of symptoms until treatment is administered,” he explains.
Rodríguez is one of the cardiologists who has seen a significant drop in the number of patients seen in interventional cardiology services. To verify this impression and put figures to the situation, the Interventional Cardiology Association has conducted a telematic survey of 71 cardiology services in the 17 autonomous communities where heart attack procedures are carried out, comparing the week of February 24 to 1 March (before the start of the alarm state) and March 16 to 22 (already in full alarm state).
The results of the analysis show a reduction of 57% in the performance of diagnostic tests, 48% less coronary therapeutic procedures, an 81% decrease in structural procedure interventions and 40% less primary angioplasties performed in heart attack cases. acute myocardium. In addition, a slight increase in the use of thrombolysis (treatment of infarction with intravenous drugs) has been observed, and 17 interventional cardiologists have been diagnosed with Covid-19 infection. This study will be published shortly in the journal REC: Interventional Cardiology.
The most serious consequence of not receiving infarction treatment or receiving it too late is that it increases the probability of sudden death, which is an arrhythmia that triggers cardiac arrest and, if not stopped in time, death. Rodríguez remembers that the heart attack is caused by an artery that is blocked, usually by a clot. “The size of the heart attack is related to the time that passes from the obstruction until it is remedied by procedures such as angioplasty,” he explains.
In less severe cases, the symptoms of an unattended heart attack may disappear temporarily, but the cardiologist warns that, “in the end, the disease appears after weeks or months and the heart does not work well again” . The result may be heart failure. “What we are going to see in the short and long term are complications related to advanced heart attacks that we have not seen for a long time and, probably, an increase in cardiovascular mortality,” predicts the expert.
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For this reason, in order to avoid these possible complications, it exhorts those affected to not let fear or other reasons prevent them from doing what has always been advised, with or without coronavirus, in case of heart attack: call 112 as soon as possible. before. “If necessary, those who answer the call will send a medicalized unit to the home or to the public thoroughfare and will transfer the patient to the reference hospital, where the heart attack code has previously been activated,” says the cardiologist. However, he clarifies that “if by Specific problems -especially these days- the 112 does not work properly, you can go directly to the hospital. ”
The symptoms of myocardial infarction are variable. They are not the same in all people, but each person usually presents a different combination. These are some of the most common: Pain perceived as a weight in the sternum area that does not change with movements or breathing, quite intense and that sometimes radiates to the jaw, neck and back, left arm and, in some cases, right arm. Cold, sweat, dizziness. Pain in the upper abdomen. Shortness of breath. Nausea and desire to vomit. Stomach heaviness. Sometimes it can be interpreted as a digestive problem.Unconsciousness.
“There are heart attacks that go unnoticed,” says Rodríguez. “The symptoms are not always as easy to interpret as when there is chest pain going to the left arm.” But it is not for that reason that you have to let them pass.
In this sense, from the Spanish Society of Cardiology they affirm that the cardiology services of Spanish hospitals, despite the pandemic, continue to be prepared to “serve acute cardiovascular patients with the same excellence as always”.