Should Heart Disease Patients See Their Doctors During The Coronavirus Pandemic
Yes. But since the beginning of the coronavirus pandemic, all health care visits in the United States have declined drastically, with some hospitals reporting a drop-off of 30% to 40% of patients.
Why arent people going to the doctor? Some are afraid of catching the coronavirus that causes COVID-19 at health care facilities. People living with heart problems might be especially wary, since cardiovascular conditions are associated with severe coronavirus disease and a higher risk of death.
Others might brush off their symptoms, assuming doctors are too busy with coronavirus patients to treat them.
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Chest Discomfort And Breathing Difficulties: Are They Caused By Covid
Aside from respiratory symptoms, COVID-19 can also cause chest discomfort, shortness of breath and breathing difficulties which appear to be similar to clinical manifestations of certain types of heart disease. Regardless of the cause, these life-threatening symptoms urge an immediate medical attention and prompt treatment.
Final Thoughts From The Doctor
If you think you have COVID-19 infection, the advice is to stay at home. However, this is a serious viral infection which causes pneumonia. If you feel your condition is deteriorating, you must seek help.
It can be hard to judge how well or badly your lungs are coping with a COVID-19 infection. Never worry about wasting anyone’s time! Lung function can deteriorate rapidly and it is always best to act earlier rather than later. If you can identify with any of the five symptoms listed here, it’s time to be calling your doctor. And to get through this pandemic at your healthiest, don’t miss these 35 Places You’re Most Likely to Catch COVID.
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When Should I Seek Medical Advice
If your symptoms begin to worsen, call your GP for advice.
If you develop severe symptoms, you should call triple zero for an ambulance and tell the ambulance staff that you have COVID-19.
What Can I Do If I Have Lots Of Different Symptoms
Long COVID can affect your whole body and you may experience lots of different symptoms, either at once or at different times. If you’re worried about symptoms 4 weeks or more after having COVID-19, contact your GP. They will ask about your symptoms and the impact theyre having on your life.
Your GP will talk to you about the care and support you might need. This might include advice on how to manage your symptoms at home.
If your symptoms are having a big impact on your life, they may refer you to a specialist rehabilitation service or a specialist that can help with your specific symptoms. This could be a physiotherapist, a dietitian, an occupational therapist, or another member of the team.
Heres some more information to help you deal with problems related to your lungs because of Long COVID:
- youre getting more breathless
- youre coughing up blood
- you have severe chest pain.
It is especially important that you seek help if you have:
- chest pain or tightness
- leg or arm swelling
- depression causing thoughts of self-harm or neglect.
These could potentially be serious, so its important that you get help as soon as possible.
If you have another medical condition and its been getting worse since youve had COVID-19, please speak to your GP.
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First Take Stock Of The Severity Of Your Infection
If you are unlucky enough to become infected with COVID-19, the episode may last up to two weeks in mild cases, or three to six weeks in severe or critical cases. The severity of COVID-19 infection has been divided into 5 groups:
Experience from Wuhan, where the virus originated, showed 81% of COVID-19 patients had mild disease, 14% of those infected developed severe pneumonia and around 5% required critical care.
When we consider if the lungs are failing, we are specifically interested in people passing from mild and moderate disease, to severe or critical. Mild to moderate disease can be managed at home. People with severe or critical disease need hospitalization.
The following are 5 symptoms/clinical signs to look out for, which will help decide if your infection is passing from moderate to critical severity, and if so, needs urgent help.
How Does Covid Cause Heartburn
According to Dr. David Putrino, PhD, Director of Rehabilitation Innovation at Mount Sinai, gastrointestinal symptoms such as constipation, nausea, general digestive issues, stomach, pains, cramps, and acid reflux have become more common in long COVID.
Even a symptom like heartburn can be one of most challenging pieces. While its relatable, if every single day youre having it, it can negatively impact your life, says Dr. Putrino.
Unfortunately, its unclear exactly why COVID causes heartburn.
One possibility is that the virus seems to be able to affect nerve cells. It could possibly disrupt the nerves that normally help your esophageal sphincters close and prevent contents from your stomach from going back up into your esophagus, says Dr. Lee. Another possibility is people may be taking antibiotics when they start having COVID-19 symptoms, even though antibiotics do not help against the virus. Antibiotics can then change the normal bacteria in your gut, which can, in turn, lead to more GERD.
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Research On Heart Problems After Covid
Research shows that there is still a lot to learn about lasting heart effects on people who have had COVID-19. In some cases, patients are left with signs of heart damage that may call for continued monitoring.
Post cites a German study in which cardiac MRIs were conducted on 100 people who had the coronavirus and survived. The researchers saw abnormal findings in 78 of these patients. Compared with those who had not had COVID-19, these patients showed evidence of scarring and inflammation of the heart muscle and its surrounding tissue . However, this study was limited by the lack of an appropriate comparison group, and subsequent studies have found a much lower incidence of myocarditis in those who had a prior COVID-19 infection.
Another small study assessed 26 college athletes who had COVID-19 with mild symptoms or none at all. Cardiac MRI showed that these students had normal EKGs and normal levels of a substance called troponin, which when elevated can indicate heart problems. Four of them had heart muscle inflammation , and two of these had inflammation of the pericardium .
Post says these data have to be considered carefully, since the sample sizes are small, and the pre-COVID heart health of the participants wasnt known.
What Should I Do If I Only Have Chest Pains
If you are worried about symptoms you can go through the NHS 111 online service.
To protect others from coronavirus, do not go to places like a GP surgery, pharmacy or hospital.
You should call 999 if you have sudden chest pain that: spreads to your arms, back, neck or jaw, makes your chest feel tight or heavy.
You should also call if the pain started with shortness of breath, sweating and feeling or being sick and lasts more than 15 minutes.
Chest pain can be a sign of other, life-threatening conditions including heart attack.
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Is A Heart Attack More Likely After Covid
That depends: Post says that heart attack has several different forms. A type 1 heart attack, caused by a blood clot blocking one of the hearts arteries, is rare during or after COVID-19 infection.
Type 2 heart attacks are more common with COVID-19, she says. This heart attack can be caused by increased stress on the heart, such as a fast heartbeat, low blood oxygen levels or anemia, because the heart muscle isnt getting enough oxygen delivered in the blood in order do this extra work. We have seen this in people with acute coronavirus disease, but it is less common in those who have survived the illness.
Blood tests have shown that during COVID-19, some people have elevated levels of a substance called troponin in their blood, along with EKG changes and chest pain. Elevated troponin levels are a sign of damaged heart tissue. Sometimes this is from a heart attack. This is less commonly seen after COVID-19.
During acute COVID-19, elevated troponin levels with an abnormal EKG are linked to higher mortality, but not in patients with a normal EKG, Post says.
What Are The Possible Heart Issues After Covid
COVID-19, the disease caused by the SARS-CoV-2 coronavirus, can damage heart muscle and affect heart function.
There are several reasons for this. The cells in the heart have angiotensin converting enzyme-2 receptors where the coronavirus attaches before entering cells. Heart damage can also be due to high levels of inflammation circulating in the body. As the bodys immune system fights off the virus, the inflammatory process can damage some healthy tissues, including the heart.
Coronavirus infection also affects the inner surfaces of veins and arteries, which can cause blood vessel inflammation, damage to very small vessels and blood clots, all of which can compromise blood flow to the heart or other parts of the body. Severe COVID-19 is a disease that affects endothelial cells, which form the lining of the blood vessels, Post says.
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Is More Research On Long Covid And Cardiac
Yes. An important one in which Altman is involved is a large National Institutes of Health study of long COVID called RECOVER. Among other efforts, RECOVER aims to recruit 17,000 patients across the United States to study not only long COVID patients but also those who recovered without long COVID and healthy controls. University of Colorado Anschutz Medical Campus is part of a consortium with the University of Utah, Intermountain Healthcare, University of New Mexico and Denver Health and Hospitals involved in the initiative.
Are There Ways To Help With Pots Symptoms
Yes. Its important that patients get plenty of fluids to increase their blood volume, Altman said, and avoid alcohol and caffeine, which dehydrate. These steps help to prevent large shifts in blood when a person stands up after lying down. Patients can help themselves with low-intensity, recumbent exercise, gradually increased over time. Altman said she also recommends compression garments, which can help to redistribute blood flow and lower heart rate.
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Long Covid: What To Do When The Patient Is Suffering Chest Pains
Dr Kiran Desai, senior clinic fellow in respiratory medicine. Dr Rebeca Bamford, specialist trainee registrar in respiratory medicine and Dr Adam Ainley, consultant respiratory physician.22 Jul 2021
Long Covid is a term used to describe ongoing symptoms four or more weeks following acute Covid -19 infection.1 It presents differently in every patient and can affect multiple organ systems, even after mild or even asymptomatic acute Covid -19.2 What is most commonly meant by long Covid is post-Covid-19 defined by NICE as symptoms more than 12 weeks after acute Covid. Symptoms for post-Covid include fatigue, shortness of breath, mental problems, chest pain and dysfunction of smell and/or taste.2
Chest pain has been found to affect up to 22% of patients 2 months following acute Covid -19.2 In a large study presented by Huang et al, chest pain affected 5% of patients six months following discharge from hospital with Covid -19.3 In a cohort study of 100 patients, in whom 17% had atypical chest pain and 20% had palpitations two to three months following acute Covid-19, imaging revealed ongoing cardiac involvement in 78% of patients and signs of myocardial inflammation in 60%.4 Only one-third of patients had been hospitalised.
Does my patient have post-Covid-19 syndrome?
In low risk patients, and depending on the clinical presentation, initial investigations that can be performed in primary care include:
- Full blood count
- Chest x-ray
How To Hang On: Coping During A Pandemic
A poll conducted in mid-April 2020 by the Kaiser Family Foundation found that 56% of adults reported that worry and stress because of the pandemic has had a negative effect on their mental health.
Respondents reported adverse effects such as trouble sleeping, poor appetite or overeating, frequent headaches or stomachaches, difficulty in controlling their temper, or increasing alcohol/drug use, and worsening chronic conditions like diabetes or high blood pressure. This is up from 45% reporting that stress over coronavirus had negatively affected their mental health in a KFF poll conducted in late March 2020.9
Right now everybody has increased anxiety, whether youre healthy as a horse, whether you have a psychiatric illness, or not, says Dr. McCann.
Telemedicine can help by connecting people with their doctors, and video meeting apps provide a means to keep up a social life as we remain in our homes. More on how to access telemedicine.
Dr. McCann also suggests exercising together with friends via video chat to support social interaction, while Dr. Bhatia recommends practicing mindfulness to ease stress.
Symptoms that are related to anxiety/panic can improve with mindfulness-based breathing exercises, says Dr. Bhatia.10 More on this technique from Dr. Bhatia.
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Hemoptysis Diagnosis And Tests
If youâre coughing up blood, your doctor will do one or more of these:
- Medical history and physical exam . This helps them gather clues to identify the cause.
- Chest X-ray. This can show whether thereâs a mass in your chest or areas of fluid or congestion in your lungs.
- CT scan . With detailed images of the inside of your chest, this test may reveal some causes for coughing up blood.
- Bronchoscopy . Your doctor runs a flexible tube with a camera on its end, called a bronchoscope, through your nose or mouth and into your windpipe and airways.
- Complete blood count . This test checks the number of white and red blood cells in your blood, along with platelets .
- Urinalysis . Some causes of hemoptysis also show up on this simple urine test.
- Blood chemistry profile. This test measures electrolytes and how well your kidneys are working.
- Coagulation tests. Changes to your bloodâs ability to clot, or coagulate, can lead to bleeding and coughing up blood.
- Arterial blood gas. This test measures the levels of oxygen and carbon dioxide in your blood. Oxygen levels can be low in people coughing up blood.
- Pulse oximetry. A probe tests the level of oxygen in your blood.
Hemoptysis Vs Similar Conditions
Your doctor will need to find out whether the blood is coming from your lungs, which is hemoptysis, or from your upper respiratory tract or upper digestive tract. This is called pseudohemoptysis. Or you could be vomiting blood, which is known as hematemesis.
- Hemoptysis causes sputum thatâs bright red or pink and frothy.
- Pseudohemoptysis looks very similar. Tests might be the only way to tell the difference.
- Hematemesis brings up material thatâs darker and looks like coffee grounds. It may be mixed with bits of food.
When to see a doctor
Acute bronchitis typically gets better on its own without treatment. If you have bronchitis and see small amounts of blood in the mucus for less than a week, itâs OK to watch and wait.
Coughing up blood can also be a sign of a serious medical condition. Call your doctor if you have any of these symptoms:
- Blood in mucus that lasts longer than a week, is severe or getting worse, or comes and goes over time
- Fever higher than 101 degrees
- Shortness of breath with your usual activity level
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When To Call 9
Any time you think you might be having a heart attack, dont ignore it. even if you are not sure that youre having a heart attack.
- Acting fast can limit damage to your heart and save your life. The 9-1-1 operator or emergency medical services personnel can give you advice that can help prevent damage to your heart.
- An ambulance is the best and safest way to get to the hospital. Do not drive to the hospital or let someone else drive you. EMS personnel can check how you are doing and start tests and lifesaving medicines right away. People who arrive by ambulance often get faster treatment at the hospital.
Every minute matters. Never delay calling 9-1-1, taking aspirin or doing anything else you think might help.
Knowing the difference between stable angina and a heart attack is important.
- The pain from angina usually happens after physical activity and goes away in a few minutes when you rest or take medicine to treat it.
- The pain from a heart attack is more serious than the pain from angina. Heart attack pain doesnt go away when you rest or take medicine.
If you dont know whether your chest pain is angina or a heart attack,
Learn What a Heart Attack Feels Like
A heart attack often causes cardiogenic shock. Its important to learn the warning signs of a heart attack and what to do if you are experiencing symptoms.
Loss Of Appetite Nausea And Vomiting
Diarrhea, nausea, vomiting, and appetite loss have been reported in a number of patients across age groups.
Theres no question at this point that GI symptoms can be a manifestation of Covid-19, William Chey, M.D., professor of gastroenterology and nutrition sciences at the University of Michigan, told AARP.
The symptoms can come on without the more typical and recognized markers of a coronavirus infection, such as fever and cough, the doctor said.
Experts explained that stomach issues can come from the virus infecting cells that line the GI tract, or as a result of your body fighting the infection.
If you experience a sudden onset of these symptoms, you’re encouraged to check with your doctor.
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