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2020 ; 72
(3
): 192-193
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
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English Wikipedia
Will the hidden specter of acute coronary syndrome (ACS) and ST-segment elevation
myocardial infarction (STEMI) emerge from the avalanche of COVID-19?
#MMPMID32768020
Kapoor A
; Yadav R
Indian Heart J
2020[May]; 72
(3
): 192-193
PMID32768020
show ga
There has been a huge impact of the COVID-19 pandemic on global healthcare
systems. Advisories across the world have appealed to people to stay at home and
observe social distancing to slow down the pandemic. However it is important to
realize as to how this is affecting acute cardiovascular care. Recent studies
from Europe and USA have reported > 50% reduction in hospital admissions for ACS
and declining rates of coronary interventions. The possible reasons for this
noticeable reduction in patients with ACS/STEMI during the COVID-19 pandemic are
multi-factorial. On one hand, it is due to change in thresholds for referring
patients of ACS/STEMI for cardiac catheterization, with fibrinolysis being
acceptable for many stable STEMI patients and conservative management being
preferred for NSTEMI patients. Theories abound on how "staying at home" strategy
may have led to an reduction in acute coronary events due to healthier lifestyle,
better compliance and reduced stress. Realistically however, a more disquieting
reason would be a "pseudo-reduction" ie. the incidence of ACS/STEMI is actually
the same, but these patients are staying away from hospitals due to fear of
contracting the infection. Lockdown restrictions have also limited transport
options for patients seeking to reach hospitals in time. Healthcare systems need
to be prepared for an anticipated downstream deluge of such untreated patients
who may present with sequelae like heart failure, reinfarction, arrhythmias,
mechanical complications etc. Scientific societies should have proactive
campaigns to alleviate patient concerns, and encourage them to seek timely
medical attention despite the COVID-19 pandemic.