Heart attacks diagnoses fell by 40 per cent during Covid-19 pandemic

Number of heart attacks diagnosed fell by 40% during the Covid-19 pandemic because patients weren’t going to hospital over fears they may catch the virus, study claims

  • Researchers looked at two cardiology units in Dumfries and Glasgow, Scotland 
  • There was a 50 per cent drop in the number of patients seen during lockdown
  • People were still suffering heart attacks but may have been afraid of hospital
  • The delay in care could be the difference between life and death, it was warned

Heart attacks diagnosis rates fell by 40 per cent during the Covid-19 pandemic, a study claims.

Figures also show the number of patients attending two NHS cardiology units for serious heart problems halved during lockdown. 

People were still suffering heart attacks during lockdown but they were not going to hospital because they feared catching Covid-19 or putting pressure on the NHS, researchers said.  

The delay in care could be the difference between life and death, experts behind the study warned.

It analysed data from the Dumfries and Galloway Royal Infirmary and Golden Jubilee National Hospital in Glasgow before and during lockdown. 

There were ‘significant’ drops in presentations to the two clinics in March, April and May, compared to before the pandemic.  

Heart attacks diagnosis rates in Scotland fell by 40 per cent during the Covid-19 pandemic (stock)

Figures show how heart attack (myocardial infraction) admissions (and therefore diagnoses) dropped by 40 per cent in the first month of lockdown

The researchers, led by cardiologist Omar Fersia at Dumfries and Galloway Royal, compared data from four time intervals.

These were 21 January to 20 February (baseline); 21 February to 20 March (transition period), 21 March to 20 April, and 21 April to 20 May (lockdown periods).

Referrals, outpatient clinics, investigations, procedures and cardiology community services — such as rehabilitation — all saw drops in attendances.

Overall there was a 50 per cent drop in the number of patients attending cardiology services, according to the study published in the online journal Open Heart.

The studies come as a new report released by heart failure charity Pumping Marvellous and Roche Diagnostics highlights gender differences in heart failure care.

A poll of 625 Britons diagnosed with heart failure found that 44.5 per cent of women surveyed were incorrectly diagnosed with another condition before receiving their heart failure diagnosis, compared with 22.7% of men.

And men said they waited on average 3.6 weeks to receive a formal diagnosis after their initial GP visit, while women waited on average just over 20 weeks.

Nick Hartshorne-Evans, chief executive of the Pumping Marvellous Foundation, said: ‘Early diagnosis of heart failure can be the difference between life and death. Yet patients are facing a battle to get a timely diagnosis.

‘This report highlights the hidden victims of heart failure and reveals the stark inequalities that women in particular are facing, with symptoms failing to be spotted, drastically impacting quality of life and resulting in unacceptable survival rates.

‘With Covid-19, the situation is only going to become worse, with an increasing backlog and strained services.’

And the number of diagnoses for myocardial infarctions, the medical name for heart attacks, dropped by 40 per cent in March and April compared with pre-Covid-19 times, from 30 to 18.

The number of patients seen for alarming symptoms — such as chest pain and breathlessness — fell by 53 per cent in the first month of lockdown, the research shows. 

There were just 18 admissions for chest pain at Dumfries and Galloway Royal between March 21 and April 20. This compared to 40 between January 21 and February 20, and 35 over the four weeks prior to lockdown.

The number of patients referred by their GP to cardiology outpatient clinics, for diagnostic tests or follow-up appointments, fell by 80 per cent, from 386 to 76.

As a result, face-to-face clinic visits fell by 93 per cent, from 474 to 30, alongside a substantial increase in the use of the virtual clinics.

There was also a significant fall in the number of acute cardiac tests performed, with a 46 per cent reduction in cardiac troponin T blood tests — used to detect heart muscle damage — and an 87 per cent reduction in ECGs, which help to spot potentially life threatening arrhythmias. 

During the second month of lockdown, services started to pick up again, the researchers found, with only a 33 per cent reduction in heart attack diagnoses.

But it is not clear if they have yet to reach levels seen prior to Covid-19.

The researchers warned cardiology services nationally should prepare for ‘a significant increase in workload in the recovery phase and develop new pathways to urgently help those adversely affected by the changes in service provision’.

The reasons behind the dip include patients reluctance to seek help, the authors said, out of fear of catching Covid-19 or putting pressure on the NHS.

The government’s message to ‘protect the NHS’ may have also left people unwilling to put additional strain on hospitals.

Patients also may have had reduced access to primary care, like GP surgeries, because of the restructuring of NHS services.

Doctors have consistently stressed that heart problems are a medical emergency and have encouraged those with symptoms to seek help immediately. 

Commenting on the research, Professor Sir Nilesh Samani, medical director of the British Heart Foundation, said: ‘These studies show the profound impact that the Covid-19 pandemic has had on cardiology services, and also highlights the need for people with heart and circulatory diseases to regain the confidence to seek hospital treatment and care in urgent situations.

‘Hospital tests and procedures used to diagnose and monitor a range of heart and circulatory conditions are often among the vital first steps in someone’s treatment journey.

‘Delaying them could have a domino effect on the rest of their care, preventing them from accessing the specialist treatments they may need in time.

‘This could lead to patients becoming more unwell as they await care and, ultimately, more deaths.

‘As we emerge from lockdown across the UK, the growing backlog of treatments must be urgently addressed.’

It comes after a study earlier this month revealed deaths from the most common type of heart attack soared by almost 40 per cent during the coronavirus lockdown.

Analysis by University of Leeds experts found hospital admissions for heart attacks plummeted by 50 per cent in April and May in England.

The data also suggested that deaths rose from the most mild form of heart attack, which is usually treatable if patients are given quick medical attention.

Scientists behind the study say lots of very ill people appear to have been reluctant to seek help despite suffering life-threatening symptoms.

This may have been an unintended consequence of the government’s ‘Stay at Home’ messaging, according to lead author of the study, statistician Dr Jianhua Wu.

A separate study published yesterday in the journal Stroke and Vascular Neurology, showed that US hospital admissions for stroke fell by almost a third during lockdown.  

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