Health Partner

Dr KP Suresh Kumar writes about how heart patients can continue to get treatment on time.

How heart patients are losing their lives due to fear of stepping out during lockdown
Sunday, June 07, 2020 - 08:34

The writer of this article is the Chief Cardiologist at Kauvery Hospital, Chennai.

I got the call at 1.43 am. “68-year-old just brought into Emergency. Marked hypotension. Severe metabolic acidosis,” said the doctor on call. Even before the doctor said it, I knew what the next sentence was — “She doesn’t have much time.”

I got out of bed immediately and left for the cardiac centre at Kauvery Hospital.  As I drove through the empty roads of Chennai at night — streets that are now just as deserted in the daytime due to the lockdown — I went over the details I had been given about Asha, the cardiac patient who was waiting in the ER for me.

On the previous day, Asha had a bout of dizziness and fatigue. Her daughter-in-law insisted that she get an ECG at a nearby clinic, since Asha has been a heart patient for over a decade now. The ECG revealed that Asha had a complete block in her heart. She needed a temporary pacemaker to be inserted, which meant getting admitted at a cardiac centre, but Asha hesitated. She was afraid — what if she ends up catching COVID-19? It took her family all day to convince her to go to the hospital.

Even before we could shift her to the cardiac cath lab, she died in the emergency department.

What made me even more sad about the case is that the insertion of a temporary pacemaker is a simple, cheap and life-saving procedure. And there is only one reason she died — she waited too long.

She is not the only one who has died in such circumstances.

Ignoring cardiac symptoms out of fear of going to hospital

Hospitals, in the minds of most people, usually evoke the idea of cures and cleanliness. But due to the COVID-19 pandemic, people would rather stay home when they have cardiac trouble than go to a hospital. And this delay is detrimental.

Like Bhaskaran, a 74-year-old man who suffered a heart attack and then waited five whole days before coming into the hospital, despite constant chest pain and advice from a nearby clinic to undergo a coronary angiogram at the earliest. His condition had deteriorated so much by the time he finally came to us that he passed away within 20 minutes of being hospitalised.

Some patients have taken their fears to such an irrational level that they don’t even attempt to visit a clinic.

Like Nithya, a diabetic aged 42 years, who experienced discomfort in her arm and chest pain - both classic symptoms of an impending heart attack - and chose to do nothing. She told nobody all night, and then collapsed with severe chest pain and passed away the very next morning.

Bhaskaran’s and Nithya’s fears of going to the hospital were founded in a gross misconception.

Why you should never ignore cardiac symptoms

When we save the lives of patients with similar heart issues, we truly understand how important, and easy, it is to be on time and get treated.

Take the case of 70-year-old Mangalam, who initially assumed that she was only suffering from a heartburn. She thought taking a Gelusil would be enough, but her daughter who lives in the US insisted that she gets a heart check-up done. Mangalam reluctantly agreed, and that turned out to be a life-saver for her. An angiogram revealed that she had a block in her heart, and that she had suffered a heart attack. She was immediately admitted and a stent was placed in her heart. We performed the procedure on her with utmost care and wearing advanced protective equipment to reduce exposure. She is now well and alive, and back home. Her daughter who lives in the US is extremely happy that even though she couldn't fly to India to take care of her mother due to the lockdown, we were able to do so.

So, if you or somebody you know is experiencing cardiac symptoms, here are three things to keep in mind:

Adhere to physical distancing norms as far as possible, but prioritise cardiac health.

It is important to respect the rules of physical distancing and protect oneself from potentially contracting the novel coronavirus. And it is also important to seek medical attention as soon as a cardiac symptom is noticed — especially if the symptom occurs in somebody with an existent history of cardiac issues.

Nothing is more fatal, when it comes to a cardiac emergency, than a delay.

Call an ambulance to take you to the hospital if possible, so that you get there quickly and safely. Call up Casualty before you get there so that they can be ready for you. Every moment counts in a cardiac emergency, and the minutes you shave off between the time of you experiencing symptoms and receiving treatment can be the difference between life and death.

Choose the hospital carefully.

By no means am I advising people to neglect their own safety in the interest of getting to a hospital quickly. It is important to ensure that you are protected at every step. To help with this, do your research in advance to find which hospital is best to go to if an emergency arises. In Kauvery Hospital, for example, COVID-19 patients are seen and treated in designated areas by a special team of doctors, nurses and paramedics. These patients and staff do not mix with other patients, making the hospital safe for non-COVID-19 patients.

As a doctor, I’m trained to view the loss of human life as something that must be accepted only after every lifesaving attempt has been made. To me, the unfortunate cases of death due to delays in getting heart treatment are a sobering reminder of how the COVID-19 fear has grown rampant.

As medical professionals, we must do our part to teach patients to weigh the choice of stepping out of the house to go to the hospital against the extreme risk of ignoring a cardiac emergency.

So, keep the safeguards in mind, try to remain rational and calm throughout, and don’t ignore your symptoms. If you are facing a Cardiac Emergency, you can visit our 24X7 cardiac centre at Kauvery Hospital immediately.

All names have been changed to protect identity.