Taking Things to Heart

Don't Ignore Stroke or Heart Attack Signs Amid the COVID-19 Pandemic

_{As deaths and hospitalizations} from the COVID-19 pandemic continue to climb, many people have gotten the message that they must stay home and practice social distancing to lessen the likelihood of spreading or catching the disease.

Perhaps the message is being taken a little too literally.

Hospitals around the country are reporting a sharp drop in the number of patients coming to the ER with mild symptoms suggestive of a heart attack or stroke. Doctors speculate people may be deciding to try to wait out their symptoms, rather than seek care - a potentially fatal strategy.

The University of New Mexico Hospital has not yet seen a marked decline in cases, but anecdotal evidence from elsewhere in the U.S. and in Europe suggests that one is coming, says Mark Sheldon, MD, interim chief of the Division of Cardiology.

"Nobody at this point knows exactly why that it is," he says of the reported patient decline. "It doesn't make sense that there are fewer heart attacks going on at this time. The more likely explanation is that people are minimizing their symptoms, or they're just afraid to come to the hospital, because the hospitals are so overwhelmed, and they fear potentially contracting the virus infection."

UNMH has canceled elective surgeries and other procedures in order to open beds for an anticipated surge in COVID-19 patients, and many outpatient visits are being handled through telecommunication.

"We're telling them if you're stable and fine, don't come in," Sheldon says. "But certainly people that are having acute or fairly abrupt chest discomfort or shortness of breath are what we're worried about, and they need to be evaluated."

The hospital continues to provide care for patients who really need it - those who health would otherwise deteriorate. "We are still open for business for these things," he says. "Stroke and heart attack are big killers and need emergency care."

Sheldon notes the risk of infection is low for patients admitted to the hospital, because COVID patients are being kept separated from others and rooms and equipment are being regularly cleaned and sterilized.

Torsten Rohde, RN, BSN, director of the Stroke and Heart Failure Programs at UNMH, says he has also heard about the decline in heart attack and stroke cases from his peers around the country.

"Hardcore stroke and heart attack symptoms - those numbers have not significantly dropped," he says. But when, for example, someone notices their arm is tingling or their speech is slurred, they might be inclined to ignore the symptoms or decide to wait to head to the hospital.

"That really lowers their survival chances," Rohde says.

Another concern is that with social distancing, elderly people who are living alone might not have anyone around to notice their symptoms and seek help.

"Many people have stroke symptoms and aren't aware of it," he says. "That is a concern. Maybe people should make sure that their parents know how to operate an iPhone or iPad so they can Facetime and check in on their loved ones."

Meanwhile, Rohde urges people to remember the B.E. F.A.S.T. formula for spotting signs of a stroke:

· Balance - Sudden dizziness, loss of balance or coordination

· Eyes - Sudden trouble seeing out of one or both eyes

· Face - Facial weakness

· Arm - Weakness, inability to raise both arms evenly

· Speech - Impaired, slurred, difficulty repeating simple phrases

· Time - Call 911 immediately