Fears of contracting COVID-19 from hospital is believed to have led to a jump of heart attack victims who are leaving it too late to seek medical help, according to the president of the Cardiac Society.

“Unfortunately, our Emergency Department is seeing a marked increase in ‘deaths on arrival’ (patients found dead by the time ambulance arrives). These are probably due to the fact that people left it too late to call an ambulance,” Dr Robert Xuereb told Times of Malta.

Fears of contracting COVID-19 from the hospital is likely to be keeping people away even when they are experiencing issues like serious heart conditions, Xuereb pointed out.

He said that Malta had experienced an alarming reduction in hospital admissions for heart attacks, heart failure or other cardiac conditions since the COVID-19 crisis.

This was not too far off the 70 per cent drop in admissions for the same conditions reported in international centres hit by the pandemic, he added.

“While it is important to stay at home and self-isolate during the COVID-19 pandemic, it is equally vital to rush to the hospital if a heart attack is suspected. Every minute counts,” he said, adding that the hospital was taking all the necessary measures to control infection transmission among patients and healthcare workers.

If a person who experiences sudden severe chest pain does not rush to the hospital, they may experience a cardiac arrest and sudden death, he explained.

If lucky to survive it, the delay in having treatment to open the coronary artery will result in important scarring of the heart muscle and heart failure in the long term.

It is vital to rush to the hospital if a heart attack is suspected

However, Xuereb did not exclude that other factors related to lifestyle changes could also be leading to people having fewer heart attacks.

“People are generally abiding by the advice given to stay at home. A good number of people are working from home or not working at all. There is therefore less commuting to and from work. Schools are closed and parents are not rushing to take their children to school before and pick them up after work.

“This has resulted in a marked reduction in stress, which is a well-known risk factor for heart attacks,” he said.

Similarly, air pollution, which had also been linked to heart attacks, had also declined dramatically.

The closure of entertainment places with a consequent reduction in alcohol intake and tobacco use, also had a part to play.

“Exposure of a non-smoker to second-hand smoke in a closed area will result in a 30 per cent increased risk of a heart attack within as little as 30 minutes,” said Xuereb. Finally, social distancing reduces spread not only of the SARS-CoV-2 virus, but also of the common viruses known to increase inflammation of the endothelium, the lining of the arteries of the heart, the coronary arteries.

This inflammation causes rupture of the fatty plaques and blockage of the coronary arteries resulting in a heart attack.

Are people with heart issues more vulnerable to developing serious complications if they contract COVID-19?

Yes, people suffering from uncontrolled heart disease, including hypertension, are more vulnerable to develop serious complications from COVID-19. Social isolation by staying home is key to keeping these people alive.

It is even more important than ever that patients follow recommendations to eat healthily, perform regular exercise, refrain from smoking and take their medications diligently.

Keeping heart disease under control drastically reduces the vulnerability to COVID-19.

What measures is Mater Dei taking to protect cardiac patients from cross contamination?

Non-COVID patients are fully segregated from the COVID patients. A separate ‘clean’ non-COVID Emergency Department and a new non-COVID Coronary Care Unit for cardiac patients not suffering from COVID-19 have been set up.

 For those cardiac patients suffering from COVID-19, a fully equipped Critical Coronary Care Unit with all the necessary facilities, including ventilators and fully trained personnel to treat their conditions, has been set up.