The world is facing a health crisis. It all started with China but now, Europe accounts for about three quarters of new daily cases. Italy and Spain are in a very difficult situation, and France and Germany are not so far behind. The European Society of Cardiology (ESC) has recently put together a series of practical podcasts from speakers with the greatest experience in this disease.
In the first podcast in this series, speaker Barbara Casadei, Professor of Cardiovascular Medicine at the University of Oxford, highlights the importance of monitoring patients with cardiovascular disease. She points out that even now and even this year, there will be more people dying of cardiovascular disease than COVID-19. Patients with CVD or CVD risk factors such as hypertnesion, diabetes and smoking are 15 times more likely to die of COVID-19.
Prof. Casadei conveyed two key messages. In the midst of this healthcare crisis, a fact that is emerging is that at this time and particularly in the worst hit areas, hospital admissions of patients with acute coronary syndrome has reduced by 75%. This doesn't mean that acute coronary syndrome has gone away. If anything, there will probably be more patients with acute coronary syndrome, as it always happens when an infection is going on. But these patients are not coming to the hospital because they keep hearing that hospitals are dangerous places. That is certainly true these days but if these patients, with acute coronary syndrome, stay at home, and if their condition worsens, they will end up dying at home.
Prof. Casadei highlighted that even those who are coming to the hospitals with STEMI are coming later and with complications such as cardiogenic shock and therefore they require more attention and more services. She pointed out that this is an important issue and we need to be clear that "don't come to hospital" does not apply to patients with STEMI or other acute syndromes.
Her second message is that think not only inside but also outside the hospital and to lobby with your national cardiac society, your local and national government to instigate lockdown because lockdown works as has been seen in Italy and Spain. Less infection buys time. And that is very, very important to have that extra time as we have learned from Italy.
In conclusion, Prof. Casadei reiterated that "we must engage both inside and outside our workplace. We must alert our patients and the public that they need to come in to the hospital if they have chest pain and we have to be able to offer a rapid and save triage for these patients at the house, because we must continue to save the lives we know how to save at this difficult period. We also need to lobby government and local authorities because as I said, the lockdown works and buys precious time for all of us, for the patients for the doctor and the health system."
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