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Coronavirus: Increased number of late-presenting heart attacks

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(Vienna, 18 February 2021) The Division of Cardiology of the Department of Medicine II at MedUni Vienna and Vienna General Hospital has found a significant increase in the number of patients presenting late with heart attacks. The experts assume that many people ignore the initial symptoms and do not go to their doctors, either because of the coronavirus restrictions or for fear of being infected. The experts at MedUni Vienna and Vienna General Hospital urge people with chest pain to have it checked out as quickly as possible. The quicker they do this after the onset of the initial symptoms, the more likely it is that their cardiac output can be maintained and that they will survive.

Since March 2020, when the coronavirus pandemic hit Austria, the Division of Cardiology at Vienna General Hospital and MedUni Vienna has seen a 26% decline in the number of patients presenting with acute heart attack and, on the other hand, a significant extension of the time between the first onset of symptoms and coming into the hospital (from a monthly average of 398 minutes before the pandemic to 1082 minutes currently). In parallel to this, more patients have died outside University Hospital Vienna.

"The delay in coming to hospital after experiencing the initial symptoms means that it is technically more difficult to treat the occlusion of the coronary artery, since more and more solid clots form in the occluded vessel as time goes on," explains Christian Hengstenberg, Director of Cardiology, making it clear: "The longer the coronary artery remains occluded, the greater the risk of permanent damage to the heart."

Chest pain should be checked out immediately by a doctor
Heart attacks are common occurrences and, in approximately 50% of cases, are the first perceptible signs of pre-existing heart disease. This means that, prior to the heart attack, many patients have had no exposure to "heart disease". Unfortunately, this sometimes means that symptoms are misinterpreted. For example, pressure and pain in the upper abdomen is often interpreted as "indigestion". However, an ECG would instantly have shown a heart attack requiring immediate medical attention. Once an acute heart attack has been diagnosed, a cardiac catheter examination is performed as quickly as possible, as this can identify any blockage in a coronary artery and reopen it. In most cases, a stent is also inserted to keep the artery open.

"We must do our utmost to ensure that people are not afraid to come into hospitals to have any unexplained chest pain checked out," says Irene Lang, Head of the Cardiac Catheter Section of University Hospital Vienna.

From a cardiologist's perspective, it is therefore particularly important to have any chest symptoms immediately checked out by a doctor. Specifically, if chest pains persist for more than 10 minutes, the emergency services should be called, and the patient admitted to hospital. "In hospital, we can quickly establish whether the symptoms are life-threatening and treat them immediately, if necessary," explains Hengstenberg.