As care teams on the front lines provide resources and care close to home, cardiovascular teams are collaborating with experts internationally. Cardiovascular care teams are prepared and ready to respond, thanks in part to clinical guidance released and informed by American College of Cardiology experts globally.
Hadley Wilson, MD is the executive vice chair of Atrium Health’s Sanger Heart & Vascular Institute and acts as the Chair of the Membership Committee, in addition to serving on the American College of Cardiology’s Board of Trustees (ACC). In this role, Dr. Wilson and cardiologists across the globe are sharing best practices, key information and guidance through digital mediums such as Twitter, teleconferences and webinars.
As coronavirus evolves regionally, Dr. Wilson and the teams at Sanger are also continually assessing the best ways to care for heart patients and protect them from unnecessary risks. Care teams meet daily, and Sanger is now offering virtual visits for cardiovascular patients.
How are cardiovascular efforts contributing to the global effort to fight coronavirus and care for patients with heart disease?
According to Dr. Wilson, the American College of Cardiology is a leader not just in the U.S., but internationally when it comes to guidelines in treating heart disease. There are members in nearly every country, with chapters in 42 countries around the world. The ACC virtual conferences have included cardiologists from China, Italy, and beyond who offer invaluable perspectives on the coronavirus pandemic and best practices for clinicians who are treating cardiac patients with coronavirus.
“We are clinicians without borders,” says Dr. Wilson. “It’s a moral imperative that we work together to stop the spread of coronavirus. Hopefully, we can prevent it from spreading further and also prevent secondary recurrence.”
How does coronavirus affect cardiovascular patients?
In the general population, the overall fatality rate from coronavirus remains low at 2.3 percent. However, in those with cardiovascular disease the fatality rate is 10.5 percent; in those with hypertension, the rate is 6 percent.
For those who have been affected by coronavirus, “Most people – about 80 percent – are asymptomatic or mildly symptomatic, but about 15 percent of coronavirus patients become ill or even severely ill,” says Dr. Wilson. “A small but important percent need to go on ventilators and may experience heart failure. We know the virus can affect the heart in about 40 percent of serious cases.”
For those who have a history of heart disease, coronavirus can cause serious cardiac symptoms in addition to pulmonary symptoms. Shortness of breath, heart arrhythmias, weakening of the heart, and symptoms associated with heart failure are all possible.
“Many of those patients would eventually have to come to the cardiac catheterization lab and have mechanical support for their heart and lungs,” Dr. Wilson explains. “We are fully prepared to treat these patients, if that were to happen regionally,” he adds. The cath labs and ICUs across Sanger locations have the necessary equipment and care teams to handle these patients and are following the protocols issued by the ACC to ensure both patient and worker safety.”
What are the recommendations that have been issued by the American College of Cardiology?
Clinicians should be aware that patients with underlying cardiovascular disease are at higher risk of contracting coronavirus and have a worse prognosis.
For patients with cardiovascular conditions, clinicians should plan to quickly identify and isolate any with coronavirus symptoms including coughing, fever, and difficulty breathing.
“Any areas, such as cath labs, used to treat cardiovascular patients with coronavirus should be disinfected before and after treatment, and should be left alone for an hour after post-treatment disinfecting,” says Dr. Wilson. “If a positive pressure airway is used, it needs to be cut off after so as not to spread the virus outside of the room.”
Healthcare personnel caring for patients with confirmed or possible coronavirus should adhere to CDC recommendations for infection prevention and control. Doctors, nurses, and other healthcare providers need to use standard and transmission-based precautions when treating patients with coronavirus, including the use of Personal Protective Equipment (PPE) and N95 masks. “Use protective gear – such masks and gloves -- judiciously and appropriately,” Dr. Wilson advises.
When triaging patients who may have been exposed to coronavirus, the ACC recommends triaging coronavirus patients “according to underlying cardiovascular, diabetic, respiratory, renal, oncological, or other comorbid conditions for prioritized treatment.”
Cardiovascular patients without coronavirus symptoms should not be tested for coronavirus at this time.
What should you do if you have a history of heart disease?
“Social distancing really does work to prevent illness and stop the further spread of coronavirus,” advises Dr. Wilson. “If you’re elderly and have a heart condition, heed the warnings and stay home.” It’s especially important to remember that younger people may seem healthy, but can still spread the virus.
“If you’re not symptomatic (coronavirus symptoms include fever, cough, and difficulty breathing), you don’t need to get tested. It’s best to just stay home,” says Dr. Wilson.
However, if you have heart disease and experience coronavirus symptoms, you can contact the Sanger team at 877-999-7484 to pursue a virtual visit. Many healthcare teams -- including those across Atrium Health -- are offering virtual visits at this time. Atrium Health’s free online risk assessment can also help you decide the best steps to take if you’re concerned that you may have been exposed to the virus.
View the American College of Cardiology’s complete clinical guidelines on coronavirus
Read more about Atrium Health’s coronavirus response
Stay informed with all of Atrium Health’s latest coronavirus updates
