These past few months, ER admissions have dropped between 40-50%, a fact that is causing doctors to worry that heart attack and stroke patients are putting off going the ER because of fears about contracting COVID-19.
“We are very concerned about the fact people are not coming in when they need to come in,” says Lisa Moreno, MD, an emergency physician in New Orleans and the president-elect of the American Academy of Emergency Medicine.
This fear is perfectly understandable: We are in a middle of a pandemic, which means once routine actions are now fraught with danger. However, in this circumstance, if you are experiencing signs of a heart attack or stroke, it is vitally important to seek medical help immediately. Delaying care could have significant consequences, including death.
Hospitals have implemented a number of protective measures
The good news is hospitals have implemented a number of measures to protect patients, including prescreening patients at the door, requiring every person in the hospital to wear a mask and establishing separate areas for patients who test positive for COVID-19 and patients who test negative.
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“We are doing our absolute best to make sure COVID-19 patients are separated from non-COVID-19 patients,” Moreno says.
She points out that although there is a testing shortage for people within the community who might be experiencing symptoms, hospitals usually do have enough tests for every patient who is admitted. These tests are quick, usually delivering results in under an hour; patients are not sorted into COVID-19 versus non-COVID-19 areas of the hospital until their test results come back.
“This is all over the country,” says Moreno, who, in her position as president-elect of AAEM, has been in communication with ERs nationwide. So far what she is hearing is that hospitals have the resources to perform rapid tests for all admitted patients—although there still aren’t enough tests to administer them to visitors, which is why no-visitor rules have been implemented.
So, what are the signs you are experiencing a heart attack or stroke, and what should you do if you notice them?
Know the signs of a heart attack or stroke
It’s important to know the warning signs of a heart attack or stroke. For a heart attack, warning signs include chest discomfort, which can feel like squeezing, an uncomfortable feeling or pain. This discomfort can persist, or it can last for a couple minutes, go away, then come back. Other warning signs include jaw, neck or back pain, discomfort or pain in the arm or shoulder, lightheadedness, nausea or vomiting, or shortness of breath.
Moreno cautions that heart attack symptoms can differ slightly in men and women, with women less likely to experience chest pains and more likely to notice other symptoms, such as shortness of breath, nausea or vomiting and back or jaw pain.
Warning signs of a stroke include sudden numbness or weakness of face, arm or leg muscles, especially on one side of the body, sudden confusion, trouble speaking or understanding speech, trouble seeing in one or both eyes, sudden dizziness, loss of balance or coordination or a sudden severe headache with no known cause.
It’s also important to know that COVID-19 has been found to cause blood clots that can lead to severe stroke. Younger patients have been experiencing strokes even when their symptoms are mild. We still don’t know a lot yet about the connection between COVID-19 and strokes, but it is an area of concern.
Call your doctor or the local ER if you are in doubt
If you are experiencing symptoms and have any doubts about whether you should go in, telemedicine can serve as an initial screening measure.
“If a patient is in doubt, […] they should check and see if their local ER department or doctor does telemedicine,” Moreno says. Telemedicine offers a contactless way to describe your symptoms to a doctor, in the safety of your own home, so they can help you determine whether this is a situation warranting emergency care.
The minute you start having any symptoms that might indicate a heart attack or stroke, contact your primary care doctor or your nearest ER so you can describe your symptoms and provide any relevant medical history.
After you do so, a doctor can make a recommendation as to whether you should come in or not. In the event the symptoms are indeterminate, they can also make it a point to call back at a later time in order to check on you.
If you are high-risk, be extra vigilant
Moreno cautions that if you have any risk factors for heart attack or stroke, you should be extra vigilant. Even in normal times, she points out, a lot of patients are reluctant to go the emergency room, often dismissing their symptoms as mild discomfort or not that bad. It’s usually concerned friends or family members who encourage people to seek care.
Now, given the risks, patients are even less likely to seek care, while family members are more reluctant to encourage their loved ones to go the ER. Moreover, physical distancing also means the highest-risk people are likely seeing a lot less of other people—decreasing the likelihood that others will be around to notice unusual behaviors that could be a sign of an health emergency. That’s why it’s really important to be extra vigilant if you are in a high-risk category, as it’ll be that much more critical that get the medical care you need before it is too late. The risks of delaying care are too significant to ignore.
