Coronavirus and heart disease

Coronavirus and heart disease

We have seen it fit to share the below information from the British Heart Foundation. However, should you be unclear or feel you need to speak to someone in more detail, please call to speak to our doctor.

I have a heart or circulatory condition – am I at increased risk of coronavirus?

We know that this is a frightening time for lots of people, especially if you have an existing health problem. Most people with coronavirus (COVID-19) have mild symptoms and make a full recovery. Having a heart and circulatory condition probably doesn’t make you any more likely to catch coronavirus than anyone else. But if you have a heart condition it may mean that you could get more ill if you catch it, which is why it’s really important to protect yourself.

Anyone with a heart condition is considered high risk of more severe complications of COVID-19 coronavirus.

Should I still call 999 or go to hospital if I’m worried about my health?

Whether or not you have Coronavirus symptoms, it’s essential to dial 999 if you have symptoms that could be a heart attack or stroke, or if your heart symptoms get worse. We are hearing that fewer people are being seen in hospital with heart attacks in recent weeks, which suggests that people are not seeking help when they should do. Don’t delay because you think hospitals are too busy – the NHS still has systems in place to treat people for heart attacks. If you delay, you are more likely to suffer serious heart damage and more likely to need intensive care and to spend longer in hospital.

You should always dial 999 immediately if your chest pain is sudden, spreads to your arms, back, neck or jaw, and feels heavy or tight, or if you become short of breath or start to feel sick.

You should also dial 999 if you have signs of a stroke, such as your face drooping on one side, can’t hold both arms up, difficulty speaking. You should also dial 999 if you are having severe difficulty breathing (such as gasping for breath, choking, lips turning blue, or not being able to get words out.)

Am I in the “extremely vulnerable” group who need to stay at home for 12 weeks?

Some heart patients are considered at extremely high risk of severe illness from coronavirus. You are classed as extremely vulnerable (at highest risk) if:

  • you have had a transplant at any time, including a heart transplant
  • you are pregnant and have significant heart disease – defined by experts as any of the following: coronary heart disease (if you have symptoms), hypertrophic cardiomyopathy (if it affects your heart function), thickening of the heart muscle (left ventricular hypertrophy) caused by high blood pressure, pulmonary arterial hypertension, a narrowed or leaking heart valve if this is moderate or severe, heart failure that affects your left ventricular function, significant congenital heart disease

If you are in one of these groups, you should protect yourself by staying at home, and minimising contact with people you live with, for the next 12 weeks. This is called shielding. If this applies to you, you will be contacted directly by the NHS with further advice. If you think you fall into one of these categories but have not received a letter, email or text by now, you should discuss your concerns with our doctor.

I don’t fall into one of those groups: am I still at high risk from Coronavirus?

Even if you are not at highest risk, you may still be at particularly high risk because of your heart condition if:

  • You have heart disease and you’re over 70
  • You have heart disease and lung disease or chronic kidney disease
  • You have angina that restricts your daily life or means you have to use your GTN frequently
  • Heart failure, especially if it restricts your daily life or you’ve been admitted to hospital to treat your heart failure in the past year
  • Heart valve disease that is severe and associated with symptoms (such as if you regularly feel breathless, or you have symptoms from your heart valve problem despite medication, or if you are waiting for valve surgery). A heart murmur that does not cause you symptoms doesn’t put you at high risk
  • You’re recovering from recent open-heart surgery in the last three months (including heart bypass surgery)
    Cardiomyopathy (any type) if you have symptoms such as breathlessness, or it limits your daily life, or you’ve been told you have problems with your heart function
  • Congenital heart disease (any type) if you also have any of the following: lung disease, pulmonary hypertension, heart failure, you’re over 70, you are pregnant, or if you have complex congenital heart disease (such as Fontan, single ventricle or cyanosis)

Read our information about Coronavirus if you have congenital heart disease.

If you are in one of these groups, the advice is the same as for everyone in the UK (except for the extremely vulnerable, who have to be even more careful to protect themselves): stay at home apart from essential needs.

If you don’t fall into one of the groups above, having a heart condition or any of these issues means you are at high risk – again, you should stay at home, apart from essential needs:

  • Coronary heart disease, such as a past heart attack, stent, or bypass surgery (at any time)
  • Over 70 years old
  • High blood pressure (hypertension)
  • Pregnancy
  • Diabetes
  • Lung disease, including asthma
  • Chronic kidney disease
  • Stroke
  • Vascular dementia or small vessel disease in the brain
  • Body mass index of 40 or over (severely obese)
  • Smoking – because the act of smoking (putting your hand to your mouth) increases your risk of catching it, and because it damages your lung health. If you smoke, stop today

What information do you have for people with Brugada syndrome or Long QT syndrome?

If you have Brugada syndrome or Long QT syndrome and get coronavirus symptoms (especially a high temperature), you should call our doctor and tell them about your heart condition, and ideally let your cardiology team know. This is because you might need extra ECGs to monitor your heart, and your heart condition may affect what treatment for COVID-19 is right for you. It is important to try to bring your temperature down quickly by taking paracetamol, to avoid a very high temperature triggering a heart rhythm disturbance.

I have atrial fibrillation – am I at risk from coronavirus?

If you have atrial fibrillation, there isn’t enough information at the moment to tell whether it or other abnormal heart rhythm problems put you at higher risk from coronavirus. It seems likely if you have well-controlled atrial fibrillation, that your risk is lower than for the groups mentioned above.

I have a pacemaker – am I at risk from coronavirus?

If you have a pacemaker, whether or not this raises your risk from complications will depend on the reason why your pacemaker was implanted. There is no evidence that the virus itself infects pacemakers or ICDs, or that it causes endocarditis.

COVID-19 coronavirus is a new disease and we don’t know everything about who is most at risk of complications. Other heart patients may still be at particularly high risk or high risk. This list is based on the best information available from relevant experts. It’s possible that other conditions could put you at risk that we don’t know about yet, so it’s important that everyone works hard not to catch or spread coronavirus.

 

Credit: British Heart Foundation

dealing with Coronavirus

How to protect yourself from Coronavirus when you’re out and about

One of the most common questions we get asks in regard to Coronavirus and how to protect yourself: are you unwittingly bringing Coronavirus into your homes and how do you prevent this? In this article in the New York Times, infectious disease experts, aerosol scientists and microbiologists answer questions from readers about the risks of coming into contact with the virus when you leave your home to do essential shopping or receive a delivery.

READ MORE

If you want further advice on Coronavirus and how to protect yourself, call us on ‭07568 369 455.

using a face mask

Using masks in everyday life

We have been very encouraged by questions regarding putting on and using masks and gloves. We would like to address the use of masks first.

Please remember that out in the public, one need not wear hospital masks/N95 masks or even surgical masks. The masks that some of you have made at home have been brilliant. We have even come across inspiring and inventive videos of some of our patients fashioning masks from scarves!

We feel that we should first speak about masks rather than gloves. This is because from our chats with you and from the input we are receiving we found that most of you are so good with hand hygiene-washing and using hand sanitiser. This is far more powerful in itself than using gloves.

Some of you have also sent in pictures of your own wearing masks in public areas (and especially supermarkets). This has been great to see!

Thank you for being so responsible and protecting others. Remember we should all wear masks to protect each other – I will wear a mask to protect you and you wear a mask to protect me etc.

We have searched all over to find a video that is brief enough and clear enough on putting on and taking off masks. We did manage to find one (that is also not targeted to the medical professionals only).

In order for a mask to offer protection — rather than becoming a vehicle for COVID-19 germ-spreading — it must be handled, worn and stored properly. This step-by-step video on mask-wearing covers the how-tos and the do’s and don’ts of mask use, with tips from Sarasota Memorial nurse Jennifer Sorensen, RN (Registered Nurse in the USA).

The video addresses mask use in hospital but more importantly also in/by the general public.

As always, should you have any questions about your health or about what to do or how to behave (responsibly for your own health), please do get in touch with us to speak to the doctor.

Please watch the video below:

 

social distancing guidelines

Is six feet too close?

Social distancing guidelines recommend that people stay six feet apart in public, based on how far most large droplets from a cough or a sneeze travel. But that may not be enough, especially if your health is vulnerable or you’re in an enclosed space.

Smaller droplets called aerosols that could spread the virus might be carried farther by air currents. They’re produced not only when you sneeze or cough, but also when you simply breathe or talk.

(We created a 3-D simulation to show just what happens in the 20 minutes after an infected person coughs indoors. We also used augmented reality — accessible with the NYTimes iOS app on a newer iPhone or iPad — to show how the six-foot guideline could apply in real life.)

Image

All the more reason to wear a mask

Barriers of cloth or other materials can stop large particles from landing on your nose and mouth, while disrupting the trajectory of your own coughs and sneezes.

Worried about surfaces?

Most people catch the virus by inhaling droplets that an infected person has just breathed out, not by touching a surface where it may be lurking. So the usefulness of widespread public disinfecting remains up for debate.

 

New York Times

Heart failure advice during COVID-19

Heart failure advice during COVID-19

  • People living with heart failure are particularly vulnerable to COVID-19
  • Social distancing/isolation is advised by Public Health England for the over 70’s and those in the vulnerable group. If you have heart failure you are considered vulnerable
  • It is important to reduce the significant risk to you by minimising face to face interaction with hospitals, GPs and other health care professionals
  • Please take care of your general wellbeing by eating and drinking well, exercising as you would usually within your home and taking your prescribed medication
  • If you require any support or advice with regards to your management, please contact us

Green – monitor your symptoms

  • No changes in your breathing
  • No changes in leg swelling
  • Weight stable
  • You are as active as usual

Continue to weigh daily, take medications as prescribed

Amber – contact your heart failure nurse or GP for advice if symptoms persist

IT IS IMPORTANT TO SEEK HELP TO AVOID DETERIORATION AND POSSIBLE ADMISSION TO HOSPITAL WHERE RISK OF COVID-19 IS GREATER

  •  Breathing is more difficult than usual and worsens on lying down/wakes you in night
  • Legs increasingly swollen
  • Weight has increased 4lbs/2kg over 2-3 days
  • Your heart medication has been changed and your heart failure team are not aware

Continue to weigh daily, take prescribed medications, follow advice given from specialist team regards altering medications and ensure you have any requested blood tests

Red – contact your heart failure nurse/GP/111- dial 999 if you feel very unwell

  • New onset chest pain – not relieved by GTN
  • Persistent rapid heart racing/palpitation
  • Difficulty breathing whilst resting
  • Severe leg/abdominal swelling
  • You have had a blackout

 

Credit: Imperial College Healthcare 

The Mayfair GP in COVID Research and helping the NHS

In addition to our patients using us and hence taking additional stress away from an already overstretched 111 and other NHS services, we are contributing in other ways towards the fight against Coronavirus.

Our doctors are assisting the NHS in every capacity that they can on a daily basis.

They are also involved in research conducted by Oxford University and the NHS. This trial involves the use of the drug called Hydroxychloroquine in people aged 50 years and older with underlying health conditions and in those aged 65 years and older.

At the moment we really do not have enough information about whether any benefits from taking this drug outweigh any possible harms from the drug. We do not, therefore, know if this drug works for COVID-19. They are therefore looking to assist in a proper trial* so that we have the information we need to guide the provision of the best care for all.

*PRINCIPLE PIL v1 27-MAR-2020 REC No.20/SC/0158 IRAS No: 281958

diabetes and coronavirusDiabetes and Coronavirus

If you have coronavirus symptoms, however mild:

  • Do not go to a GP surgery, pharmacy or hospital. Call us for advice via a telephone appointment
  • If you live alone, stay at home for 7 days from when your symptoms started
  • If you live with someone who has a continuous cough or a high temperature, you should stay at home for 14 days from the day the first person got symptoms. If you then develop symptoms, you should stay at home for 7 days from the day your symptoms start, even if it means you’re at home for longer than 14 days
  • Follow the advice of our doctors or your diabetes team regarding your medication
  • If you routinely check your blood sugar at home you’ll probably need to do it more often
  • If you don’t check your blood sugar levels at home, be aware of the signs of a hyper (hyperglycaemia), which include passing more urine than normal (especially at night), being very thirsty, headaches, tiredness and lethargy. You should contact us if you have hyper symptoms
  • Stay hydrated – have plenty of unsweetened drinks and eat little and often

If you have type 1 diabetes, check your blood sugar at least every four hours, including during the night, and check your ketones. If your blood sugar level is high (generally 15mmol/l or more, or 13mmol/l if you use an insulin pump, but your team may have given you different targets) or if ketones are present, contact your diabetes team.

If you take a certain type of diabetes tablet called SGLT2i and become unwell, you should stop taking these. You need to check your ketones and your blood sugars (if you’ve been told to do this and have the kit), and speak to your healthcare team. The brand names of these tablets are Forxiga, Invokana and Jardiance. Taking these tablets when you’re not very well could increase your risk of developing diabetic ketoacidosis (DKA), so you need to know the symptoms to look out for.

Keep eating or drinking – if you can’t keep food down, try snacks or drinks with carbohydrates in to give you energy. Try to sip sugary drinks (such as fruit juice or non-diet cola or lemonade) or suck on glucose tablets or sweets like jelly beans. Letting fizzy drinks go flat may help keep them down. If you’re vomiting, or not able to keep fluids down, get medical help as soon as possible.

How Coronavirus can affect people with diabetes

Coronaviruses can cause more severe symptoms and complications in people with diabetes, as well as in older people and those with other long-term conditions, such as cancer or chronic lung disease.

Everyone with diabetes, including those with type 1, type 2 and gestational, is at risk of developing a severe illness if they get Coronavirus, but the way it affects you can vary from person to person.

When you have diabetes, being ill can make your blood sugar go all over the place. Your body tries to fight the illness by releasing stored glucose (sugar) into your bloodstream to give you energy. But your body can’t produce insulin to cope with this, so your blood sugars rise.

Your body is working overtime to fight the illness, making it harder to manage your diabetes. This means you’re more at risk of having serious blood sugar highs and lows, as well as longer-term problems with your eyes, feet and other areas of your body.

For most people, Coronavirus is a mild illness, but some people develop a more serious form of the virus and could die.
It is important that people with diabetes follow the sick day rules should they become ill from any illness.

Advice from Dr Kaushal and Diabetes UK

high blood pressure and coronavirus

High blood pressure and Coronavirus

Blood pressure is the pressure of blood in your arteries – the vessels that carry your blood from your heart to your brain and the rest of your body. You need a certain amount of pressure to get the blood moving around your body.

Your blood pressure naturally goes up and down throughout the day and night, and it’s normal for it to go up while you’re moving about. It’s when your overall blood pressure is consistently high, even when you are resting, that you need to do something about it.

High blood pressure is serious. If you ignore it, it can lead to heart and circulatory disease, such as a heart attack or stroke. It can also cause kidney failure, heart failure, problems with your sight and vascular dementia.

Symptoms of high blood pressure

High blood pressure rarely has noticeable symptoms. But the following can be symptoms:

  • Blurred vision
  • Nosebleeds
  • Shortness of breath
  • Chest pain
  • Dizziness
  • Headaches

More than 1 in 4 adults in the UK have high blood pressure but many will not know they have it. Many people with high blood pressure feel fine. But even if you feel fine, you should still have your blood pressure checked regularly. If you’re a healthy adult over 40, it’s recommended that you get it checked at least once every five years. But if you’re at increased risk of high blood pressure, you should have it checked more often, ideally once a year.

Please get in touch to get your BP measured, to speak about family history and your risk, arrange tests and appropriate medication. We believe in medications as a last resort and so try hard to avoid starting patients on medication, concentrating on lifestyle changes first. We also try to wean patients off the medications if appropriate measures result in the blood pressure control improving.

High blood pressure medications and Coronavirus

There has been a lot of speculation about blood pressure medications and the increased risk of getting/worsening the effects of Coronavirus. This has led to many discussions and opinions and the advice of our doctor would be that each case is individual and dependant on your other risk factors and current health issues. Contact us if would like to discuss your individual case with our doctor.

We would also like to reassure you there are currently no shortages of heart medications as a result of Coronavirus and many pharmacies offer a home delivery service if you are self-isolating and are unable to have a friend or family member pick up your prescription. Contact us to help you arrange this if needed.

 

Credit: British Heart Foundation

fair weather warning during coronavirus

Why is the weather not playing ball?

We think the weather is reminding us that in these grim times, there’s a reason to smile and value life & nature. Thank you all so much for staying home. We appreciate how difficult it is not meeting family and friends.

Please enjoy the sun and the vitamin D (safely in your private garden/balconies/through the window)! While we have the warm weather and the sun, please do remember to apply sunblock and keep your skin well-moisturised.

If travelling out for necessities, please remember to keep a 2m distance between yourselves and others.

It is also a good idea when going into an enclosed space like a shop, to wear a mask. This helps protect others and as such if we all wear masks then we protect each other.

If you have any questions about skin conditions or vitamin D deficiencies, please get in touch.

asthma and coronavirus

Asthma and Coronavirus

Asthma is a common lung condition that causes occasional breathing difficulties.

It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults.

There’s currently no cure, but there are simple treatments that can help keep the symptoms under control so it does not have a detrimental impact on your life.

Symptoms of asthma

The main symptoms of asthma are:

  • coughing: especially at night or in the cold (if that is your trigger)
  • a wheeze: whistling sound when breathing
  • breathlessness and/or a tight chest (which may feel like you’re struggling to breathe)

If you develop symptoms of COVID-19 and you have asthma:

  • You need to stay at home until you are no longer contagious to others.
  • You don’t need to contact 111 to tell them you are staying at home.
  • If your COVID-19 symptoms don’t go away after 7 days or get worse, or you are having difficulty breathing, call us for advice, or 999 if you need emergency care.
  • If you get an asthma cough and are not sure whether your cough is a symptom of COVID-19 or related to your asthma, please speak to our doctor

Keep following your asthma action plan (if you have one) to manage your asthma and so you know what to do if your asthma symptoms get worse.

If you are having an asthma attack, call 999 for an ambulance as usual, and tell them you have COVID-19 symptoms. Carry on taking all your usual asthma medicines as normal.

Written with advice from Dr Vibhu Kaushal and asthma.org.uk

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Covering general practice, paediatric care, health screening, sexual health and lifestyle medicine, you can be assured of a discreet, flexible, convenient and personal service.

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