Corona Bites: Day Thirty-Two
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)
- Lung disease, including asthma
- Chronic kidney disease
- 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