Wil's Blog

Wil's Blog

Tuesday 21st April 2020

In a statement from Heart Valve Voice and the UK’s professional cardiovascular societies, we highlighted a concerning trend across the UK showing the number of people presenting at hospitals with cardiac conditions has reduced significantly due to failures to act on the deterioration of symptoms and putting people lives at greater risk. 

The statement, which you can read here, was a joint message from Heart Valve Voice and the UK’s leading cardiovascular societies. In it, we stressed three main points:

  1. Whilst there may be disruption and delays to appointments and treatments, urgent treatment for heart valve disease will still be undertaken.
  2. Patients awaiting treatment must monitor their symptoms closely and report any changes to their clinical team.
  3. When this crisis relents, and it will relent, we will be making the case that valve disease patients are treated as a matter of urgency.

COVID-19 has placed a huge strain on the healthcare system and there is a growing concern that in response to this patients are increasingly reluctant to present at hospitals despite needing medical help. The reasons for this are complex, but two main factors affecting a downturn in admissions are a fear of contracting COVID-19 virus at hospitals and public concern in the volume of hospital admissions meaning patients don’t want to overburden hospitals.

The data released by Public Health England for March shows that the number of people presenting with a suspected heart attack had halved. From an average of 300 cases per day at the start of the month to an average of 150 per day by the end of the month. In raw numbers, it would be the equivalent of a drop of nearly 5000 patients across the month.

Broken down by age groups over 65s show the second-largest reduction in admissions. With this group at greater risk of cardiac illness, and in particular heart valve disease, these numbers are alarming and action must be taken to halt this trend.

My message to patients is simple. If your symptoms deteriorate you must report it to your clinicians immediately. Heart Valve Voice has created a symptom tracker that all patients awaiting treatment for heart valve disease should be using every day.

Click here to download Heart Valve Voice’s Symptom Tracker.

Anyone who experiences severe symptoms must seek medical help immediately. Leaving a severe cardiac illness untreated can be deadly.

Hospitals up and down the country continue to treat patients in emergency cases and your health continues to be important to all clinicians. In addition to this, hospitals are taking every precautionary measure available to them to contain the spread of the COVID-19 virus.

I must stress that although the COVID19 virus has put an unprecedented strain on our services, hospitals continue to have the capacity to care for you, and all emergency admissions continue to be treated in a safe environment and with the same veracity and level of expertise as before this crisis.

The sense of fear of the COVID19 virus has manifested in the population is understandable, but have faith that your health service is here to care of you when you need it.

I asked Prof Nick Curzen, President of the British Cardiovascular Intervention Society, for his thoughts on this :

“The reduction in acute cardiology admissions across the clinical spectrum is concerning, particularly if it is the result of sick patients not asking for help. Firstly, I must start by stressing, as Wil has previously, that any patient whose symptoms worsen should seek help, either from the GP, 111 or by attending A&E.

Even though COVID presents an unprecedented challenge to the NHS, which has led to a suspension of non-urgent elective work, there is still the capacity to treat patients who are acutely unwell. Current guidelines for interventional cardiologists include 2 important recommendations for patients with severe aortic stenosis, especially those who are on a TAVI waiting list.Firstly, that if a patient awaiting TAVI becomes unwell and needs to be admitted, we should endeavour to get the TAVI procedure done for them on that admission. Secondly, whilst cardiac surgery capacity is severely restricted by the current diversion of intensive care services to patients with COVID, patients presenting acutely unwell for the first time with aortic stenosis will be assessed to see if they can have a TAVI, and if suitable, will have that procedure on that admission if clinically necessary

TAVI will, therefore, be a crucial tool in managing heart valve disease patients during and after this crisis. Right now, it gives us the ability to treat and discharge a suitable patient in a streamlined pathway which protects them from long term admission and frees up much-needed bed space. And once this crisis relents, it will be vital in managing the disruption COVID-19 has caused to waiting lists.”