Survey outlines the impact of COVID-19 on Heart Patients and Heart Patient Organisations

Several studies have confirmed that those most vulnerable to adverse or poorer outcomes from contracting the coronavirus are individuals living with cardiovascular disease, especially those living with heart failure, hypertension and diabetes.

Ironically at a time of greatest need when heart patients rely on the support of patient organisations, COVID-19 is also significantly impacting on these support structures. A survey conducted at the beginning of this month (April 2020) by the Global Heart Hub, the umbrella organisation for heart patient organisations across the world, has shown that, as expected, there has been an increased demand for information and support from patients, their carers and the general public, but at the same time, patient organisations themselves are battling the effects of the pandemic.

The Global Heart Hub survey on the impact of COVID-19 on patient organisations across 19 countries has reported that already almost half these groups have experienced a cut in their income and a third have had to reduce their staff numbers. The principal reason for reduction in income is cancellation or postponement of events which were either primarily fundraising events or events that were dependent on sponsorship. Interestingly, across some of the organisations who reported no change in income status are those who had already received their grant or sponsorship income for 2020, but their future income may be in jeopardy if the crisis continues over the rest of the year. In reporting on the increased demands on organisations, the ‘stay at home’ policy across the world has forced most organisations to provide information and support online or by telephone. Many organisations reported that one of the reasons for the increased outreach from patients, carers and members of the public has been the difficulty experienced in accessing GP’s and Pharmacists.

What is reassuring to note from the survey results is that patient organisations are keeping themselves informed through reputable sources and the vast majority of patient organisations (81%) are in direct contact with clinical experts for advice and guidance.

The global survey reports that the top three greatest impacts of the pandemic on patients are:

  • Heightened fear and anxiety from their vulnerability due to their underlying health issues;
  • Concerns and fears as a result of cancelled or postponed appointments and procedures;
  • Increased anxiety due to isolation and loneliness as a result of the ‘stay at home’ or ‘cocooning’ policies.

As many of these individuals are older persons with already limited social interaction opportunities, the restrictions on movement coupled with the fear of contracting the virus are a cause of considerable anxiety with many commenting on their ‘fear of the future’. Equally of great concern to those with heart conditions is access and availability of COVID-19 testing. The vast majority of patient organisations (82%) across the world commented that individuals with heart conditions are not viewed as ‘urgent’ for COVID-19 testing.

Many people living with heart conditions report a range of fears and anxieties which are largely the same range of fears as everyone else – fear of infection, uncertainty about the future, economic uncertainties etc. Understandably however, the fear of being infected is the number one fear of all heart patients across the world. As a consequence, patients are now very fearful of going to hospital (in case they are exposed to the virus). This is reflected in the experience of hospitals across Europe and beyond where many people with heart attack symptoms are delaying or avoiding going to hospital, as evidenced by a dramatic reduction in heart attack admissions. This has led to an urgent call by the President of the European Society of Cardiology, Professor Barbra Casadei who emphasised that “Instructions to ‘stay at home’ and ‘don’t come to hospital’ do not apply to those with heart attack symptoms”. She added that people with symptoms of heart attack should immediately phone the emergency services because hospitals have designated areas for heart attack patients to prevent the spreading of the coronavirus.

Equally, the fear of attending hospital is influencing heart patients to decline scheduled procedures or surgery even when it’s clinically indicated as necessary or their doctor recommends it. Consequently, some patients are avoiding procedures such as heart valve replacement for fear of virus infection post procedure. This is in spite of medical advice that there is no evidence that the virus infects implanted devices or causes infective endocarditis in those with valve disease.

Unsurprisingly, a common concern among patients and their carers is the amount of ‘fake news’ and unreliable information that is circulating on social media. Patient organisations are therefore playing a very important role in supporting patients and their carers by providing reliable and accurate information in this time of greatest need.

Croí adds its Voice to Global Call to Heart Valve Patients

Among those most impacted by COVID-19 are individuals living with heart disease or with specific heart conditions such as heart valve disease.

“People with underlying heart disease or with certain heart conditions such as heart valve disease are among the most impacted by the coronavirus because of factors outside of their control, but also due to some things under their control,” says Croí CEO Neil Johnson, who has joined a global call for heart valve disease patients and their carers to take as much control as possible of their heart health during this global pandemic.

The global COVID-19 crisis has put an enormous strain on health systems which face the battle of limiting the spread of coronavirus, while at the same time providing the treatment and care that will save lives. As a result of this, healthcare systems across the world are having to change the way they work and how they prioritise, impacting patients presenting with many conditions, including heart valve disease.

The Global Heart Hub, an umbrella organisation for heart patient organisations, is advising those living with heart valve disease and other heart problems that while there may be disruption and delays to appointments and treatments, urgent treatment for conditions such as heart valve disease still needs to be undertaken.

“Many of the indicators that suggest a patient requires early or urgent intervention are symptom driven, so it is crucial that patients monitor their symptoms and report any deterioration to their nurse, doctor or heart specialist,” says Wil Woan, chair of the Global Heart Hub Heart Valve Disease Patient Council. The Global Heart Hub’s Heart Valve Disease Patient Council, of which Croí is an affiliate, has resources to help patients track their symptoms and he is encouraging patients and their carers to use them (www.globalhearthub.org).

Referring to factors under a patients control, Croí has added its voice to the global call in response to the concerning trend of some heart patients with severe symptoms or severe disease avoiding hospitals, not attending appointments or not contacting the emergency services on time for fear of contracting COVID-19. Croí’s Neil Johnson says: “By not seeking or receiving urgent treatment, these patients may be putting their lives at greater risk. We urge these patients to monitor their symptoms closely and report any deterioration. We are aware that this is a worrying period for patients across the world whose concerns about COVID-19 and potential isolation from loved ones is hampering their willingness to seek appropriate medical advice and treatment.”

Locally, Croí, a founding member of the Global Heart Hub, is providing support to patients and their carers through this challenging time. The Croí health team is available by phone Monday to Friday to provide information and support to those living with heart disease, stroke and obesity.

The Global Heart Hub is the umbrella organisation for heart patient organisations across the world and one of its core objectives is to create partnerships, share information and to leverage the power of the patient voice to deliver the best outcomes for all patients across the world. In the case of heart valve disease, where severe disease requires treatment, the Global Heart Hub is calling on healthcare systems and physicians to ensure that those who need urgent treatment still receive it, even in these challenging times.

“It is important that, together, we make clear that when the COVID-19 crisis relents, heart valve disease patients around the world will need and should receive treatment. Cancelled or delayed heart valve surgeries or interventions will need to be prioritised because we know that early intervention is optimal in returning patients to a good quality of life,” Woan, Global Heart Hub.

Click below to download the new heart valve disease Symptom Tracker resource.

Advice For Individuals Recovering From A Recent Cardiac Procedure

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Due to COVID-19, people admitted to hospital for cardiac care are being discharged quickly to reduce their possible exposure to infection. The consequences are that many patients and carers are not getting adequate time with doctors and nurses to understand their condition and its treatment. The following information has been developed specifically for patients who have just been discharged from hospital post a cardiac procedure.

It is important to remember that our hospitals will continue to treat heart patients where urgent emergency dictates. If you have symptoms that could be a heart attack or stroke, or if your heart symptoms get worse you should still call 999 for immediate assistance

WHAT SHOULD I DO IF I HAVE RECENTLY HAD OPEN HEART SURGERY INCLUDING HEART BYPASS AND HEART VALVE SURGERY?

Patients who have recently had surgery have an increased risk of infections due to cuts/incisions which may be exposed to germs. The normal risk of infection for open heart surgery patients is low, but in the current situation you should take every extra measure to limit your risk of infection.

It is important to keep the wound site clean and dry. Observe for any signs of infection such as, redness around the wound, discharge from the wound which may be evident on the dressing, and pain or swelling around the wound site.

Your medical team will have advised you on your expected recovery before being discharged home. This includes making sure you take lots of rest in the first 2 weeks following surgery. In this time, you should continue to do gentle exercise around your home and garden. You should avoid leaving your house and follow the COVID-19 recommendations on the website around cocooning.

You should eat a healthy, well balanced diet to boost your healing and recovery.

If you do begin to feel unwell you should contact your GP, hospital medical team or call the emergency services.

WHAT SHOULD I DO IF I HAVE RECENTLY HAD A TAVI?

A TAVI (Transcatheter Aortic Valve Implantation) is a procedure that is used to replace the aortic valve. It is generally performed under local anaesthetic, but sometimes under general.

TAVI is a less invasive approach which allows the replacement aortic valve to be inserted via a catheter usually through a small incision in the groin. TAVI is now a recommended, safe and cost-effective alternative to open heart surgery for patients with severe symptomatic aortic stenosis not just at high-risk, but also at low and intermediate-risk of surgical complications.

If you have recently had a TAVI procedure, you have heart valve disease. This places you at higher risk of developing complications if you catch the COVID-19 virus.

On average it takes 2-3 months to recover fully from a TAVI procedure. Cocooning is advised to individuals who have had this procedure within this time frame.

WHAT SHOULD I DO IF I HAVE RECENTLY HAD an Angiogram or Angioplasty?

Individuals who have recently had an angiogram or an angioplasty (plus or minus stents) are usually discharged from hospital the same or following day.

You can return to light duties within a few days and are usually safe to drive a week after the procedure. We would recommend against this at present due to the increased risk of exposure to the COVID-19 virus.

Heavy lifting should be avoided while the artery is healing. If you have had an emergency angioplasty, i.e due to a heart attack you will need to take a few weeks off work and follow the advice around cocooning. For more information on advice following a heart attack click here.

There is a small risk of developing a haematoma (bruise) around the wound site, this should settle with rest. If it becomes worse or red and painful contact your GP via the telephone, for further advice.

WHAT SHOULD I DO IF I HAVE RECENTLY HAD a cardiac device implanted?

There is no evidence that the COVID-19 virus infects any type of implantable device, such as a pace maker or defibrillator. These devices can help stabilise your heart condition.

If you have recently had an ICD (Implantable Cardiac Defibrillator) or PPM (Permanent Pace -maker) fitted you should avoid heavy lifting and pulling with the affected arm for the first 4-6 weeks. This gives the device and leads a chance to settle in.

If you were advised that you had stitches in the wound site, you should still attend your GP or practice nurse to have these removed. Be sure to phone first to arrange an appointment.

You may have been told you will also need to have your device checked. This is usually around 6 months after insertion. You will be contacted by the cardiology department of your local hospital if this affects you. You may also have been set up with remote patient monitoring.

You may or may not notice when your ICD has delivered treatment, as this can vary from person to person. It can range from a fluttery feeling in the chest to an incredibly painful thump in the centre of the chest. It may be accompanied by feeling dizzy or faint.

If you experience this, you should contact your cardiac investigation team. If you continue to feel unwell after having a shock delivered you should contact the emergency services immediately.

WHAT SHOULD I DO IF I HAVE RECENTLY HAD a Cardiac ablation?

Ablation is a treatment used to treat some arrhythmias (abnormal heart rhythms). If you have recently had an ablation you may continue to have some symptoms such as palpitations following the procedure. This is very common and you shouldn’t let it concern you. It is usually takes 8-10 weeks following the procedure for doctors to determine if it has been successful.

There is a small risk of developing a haematoma (bruise) around the wound site, this should settle with rest. If it becomes red and painful contact your GP via the telephone, for further advice.

Due to the COVID-19 pandemic it is unlikely you will have you’re follow up within 8-10 weeks. You will still be seen in your local hospital but it is likely it will be delayed. This is to keep both you and the medical staff safe. Until you have been reviewed by your consultant you should continue to take your medication, and contact your GP by telephone if you have any concerns.

COVID-19: Performing CPR in the Community

FAQs for Performing CPR in the Community

The recent COVID-19 outbreak has generated many questions and concerns about potential exposure during CPR administration. The best protection from infection is to follow the recommended procedures and guidance highlighted in the FAQs below.

Can I get COVID-19 from performing CPR?

Yes, you can get COVID-19 from performing mouth-to-mouth CPR. We strongly advise anyone in the community to do COMPRESSION-ONLY CPR. Studies have shown that compression-only CPR in adults may be as effective as combined rescue breaths and chest compression in the first few minutes of cardiac arrest. It is still important to call 112 or 999 and apply an AED (Automated External Defibrillator) as normal.

It is at your discretion to perform or not to perform mouth-to-mouth on a loved one or family member. If you choose to perform breaths, it is recommended you use a barrier device, such as a pocket mask or face shield, to help protect yourself.

If you choose to perform Compression-Only CPR, first call 112 or 999 and then push hard and fast in the centre of the person’s chest, on the lower half of breast bone, until advanced help arrives. If you think the person may have COVID-19, please state your concerns to the emergency response dispatcher so those who respond can be aware of the potential for COVID-19 transmission.

Should I still do the breaths for CPR in a suspected/confirmed COVID-19 case?

In a suspected or confirmed COVID-19 case use compression-only CPR and apply an AED as soon as possible.
For a child or an infant, the cause of the heart stopping is likely to be due to a respiratory issue, so breaths are really important. Most children or infants are provided CPR by a family member or friend. Consider performing compressions and breaths, especially if you know the child/infant. If you do not feel comfortable giving breaths, or are concerned for COVID-19, you can consider only performing compression CPR until help arrives and apply the AED as normal.

Can I still use an AED?

Yes. Early AED use is still very important. AED pads can be placed on the person’s chest as directed by the AED prompts. Use the AED as directed. There are no additional directions needed for coronavirus. Clean the AED surface after use with simple disinfectant to kill the virus, following the manufacturer’s guidelines. Protect yourself and others by wearing gloves when cleaning, and then washing your hands with soap and water, or using an alcohol-based hand sanitizer. Avoid touching your face (e.g., eyes, mouth, or nose). Follow HSE guidelines on hand washing here.

After performing resuscitation - are there any precautions I should take?

After performing resuscitation, individuals should wash their hands thoroughly with soap and water for a minimum of 20 seconds; alcohol-based hand gel is a convenient alternative. See HSE guidelines on hand washing here.

I have given mouth-to-mouth. What should I do?

If you have given mouth-to-mouth resuscitation, there are no additional actions to be taken other than to monitor yourself for symptoms of possible COVID-19 over the following 14 days. Should you develop such symptoms, please contact your GP.

If you need support, you can contact the Croí Health Team on 091-544310 Monday – Friday from 9:00am – 5:30pm or you can email us at healthteam@croi.ie.

Further information:

Croí Supports Local Effort To Combat COVID-19

Local Heart & Stroke charity Croí is playing it’s part in supporting the HSE and Galway University Hospital in the fight against the Coranavirus.

“Like all charities, we are being severely impacted by the Coranavirus, both operationally and financially,” says Croí CEO Neil Johnson. “For almost three weeks now, we have ceased all face-to-face programmes and classes in the Croí Heart & Stroke Centre as many of the individuals we deal with are in the highly vulnerable group should they contract the virus. With all programmes ceased, we had an empty building which is adjacent to GUH, and we felt that it could be put to good use in the battle against COVID-19. We are delighted that the HSE are now using Croí Centre as a Contact Tracing Centre.

Furthermore, our Croí Courtyard Apartments will also be used in the current emergency. These apartments are part of our patient support services where we provide them free of charge for use by the families and relatives of those receiving emergency cardiac and stroke care in GUH. As visiting patients in hospitals is now not allowed, the apartments were not being utilised so we have offered them to GUH for use by ICU Staff on the frontline who need to stay away from their families as part of infection control,” Johnson added.

While the Croí building is now being used for other purposes, the Croí Health Team are still available and providing daily support to people living with heart disease, obesity, diabetes and recovering from stroke, through their telephone helpline (091-544310) and regularly updated information and resources on the Croí website (www.croi.ie) and across all Croí social media channels (@croiheartstroke).

Commenting on the impact of COVID-19 on Croí, CEO Neil Johnson says: “All charities are being hit very badly by the current crisis. For Croí we are no different, all our income lines have literally dried up at a time of greatest need for the supports we provide to those who are most vulnerable to the Coronavirus. We are heartened to still be receiving donations from some individuals and organisations who are in a position to do so. We know we will manage to get through this difficult period and we remain available to patients and carers to support them in whatever way we can.”

The Croí website (www.croi.ie) is regularly updated with the latest advice on COVID-19, along with practical guides and tips to help you achieve a healthy lifestyle.

If you need support, you can contact the Croí Health Team on 091-544310 Monday – Friday from 9:00am – 5:30pm or you can email us at healthteam@croi.ie.

I have just been told I have heart failure, what does this mean?

Updated March 31

If you have just been told you have heart failure you are probably particularly worried, given the global pandemic of coronavirus. Because of this you have probably been given a diagnosis in hospital and promptly discharged home, back to the care of your GP due to pressure on medical staff to make beds available, but also to reduce this risk of you catching the virus. The specialist team of nurses and health care providers that you would usually see have most likely been redeployed.

So what does this mean for you?

Firstly, heart failure sounds scary – often when people are told they have heart failure they think that their heart is just going to stop. Heart failure is a chronic disease the same as diabetes – it cannot be cured but it can be managed.

Think of your heart as two pumps one side the right side pumping blood into the lungs to become oxygenated, the left side of the heart then pumping this blood around the rest of the body. Heart failure is a pump failure. Your heart is failing to pump as efficiently as it used to. It can be right, left or both sides that fail. It can fail for many reasons as is discussed on our heart failure page.

Having a pump that is not working as efficiently as it used to leads to a build-up of fluid – a lot of managing heart failure is managing fluid. This fluid can build up in the lungs, around the stomach or in the legs, causing the following symptoms.

Symptoms:

Breathlessness, particularly on exertion, waking up breathless at night or needing to increase the amount of pillows that you sleep. Swelling in your feet and legs. Bloating and reduced appetite.

What can you do?

Remember you will be seen for follow-up and possible further investigations when the coronavirus has gone or is under control. Until then, there are things you can do at home yourself.

  • Stay at home and follow advice around coronavirus, you are not more likely to catch the virus, but if you do you are more likely to develop complications.
  • Restrict your fluid intake to 2 litres in 24 hours (unless you have been specifically told differently by a medical professional) 2 litres is enough to keep your kidneys happy but not too much that will put extra pressure on your heart.
  • Don’t use salt of any kind including low salt. Salt is a magnet for fluid and works against medication that tries to help you get rid of this extra fluid. (water tablets or diuretics such as Furosemide).
  • Check your weight first thing every morning, go to the toilet and record your weight. Make sure you’re wearing the same thing every time you weigh yourself. You are looking at what your weight is doing, not what it is. If it increases by 3lb overnight or a total of 5lb (or 2kg) in 1 week you need to speak to your GP. A weight increase indicates a build-up of fluid and is a very strong indicator your heart is not pumping as well. This may mean you need to have your medication adjusted. Often you will see your weight start to increase before you have or notice any symptoms with heart failure.
  • Take your medication often people with heart failure are prescribed water tablets or diuretics such as Furosemide or Bumetanide. It is important that you take them, if you need to leave the house or go on a long journey and are worried about finding a toilet take them later in in the day. This is ok as long as you remember to take them and that water tablets will be in your system for around 6 hours. They start working after 30 minutes and are more potent the first couple of hours. This means if you take your tablets at bedtime you will get a very poor night’s sleep.

If you experience any of the following worsening of symptoms, you should contact your GP or attend your local emergency department.

See Croí’s health page for more information on heart failure.

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

Advice From Croí, the Heart & Stroke Charity COVID-19 and People Living with Heart Disease

The coronavirus pandemic has caused great alarm and distress across the country. Understandably, many of those living with heart disease are anxious and concerned.

While people of all ages can be infected by this new virus, it presents a greater risk for people over the age of 60 years of age and those who have underlying medical conditions, chief among them is heart disease, high blood pressure and diabetes.

It’s well established that many virus infections can affect the heart, and coronavirus is no different. Viruses are known to cause inflammation of the heart muscle. While in a healthy patient this may not lead to an adverse outcome, the situation for those living with heart disease is different. If these individuals become infected with coronavirus they are at greater risk of adverse cardiac events and the outcomes may be poor.

“It is normal to feel concerned about COVID-19, especially if you are living with heart disease. While it is normal to feel anxious about how this condition might affect you, the first thing to know is that you are at no greater risk of developing COVID-19 than anyone else. However, if you do contract the virus you have a higher chance of developing complications,” says Croí Director of Programmes, Irene Gibson.

With the number of cases in Ireland increasing on a daily basis, hospitals are likely to experience an unprecedented increase in-patient admissions. Consequently, in anticipation some hospitals are cancelling clinics and limiting non-urgent activity to urgent and emergency cases so as to reduce the strain on staffing and beds.

It is important to remember that our hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellations of appointments and disruption of services.

 

How do I reduce my risk of contracting the COVID-19 virus:

For those living with heart disease, prevention is key. Currently, there is no vaccine to prevent COVID-19 and the best way to prevent illness is to avoid being exposed to this virus.

Coronavirus is spread by droplet infection – coughing and sneezing – or by close contact with someone who has the virus. As this is a new illness, we do not know how easily the virus spreads from person to person. Spread is most likely from those who have symptoms. It is very important therefore to limit close contact.

“Croí’s advice is to be extra vigilant and follow the advice of the HSE. Be aware of the symptoms of coranavirus and be extra vigilant in taking the recommended precautionary measures. Everyone has a role to play in reducing the spread of this virus and if we all take collective responsibility we will minimise the risk for everyone,” says Croí CEO, Neil Johnson.

 

Key things to remember are:

  • Stay at home as much as possible and limit your social contact, particularly with people who are unwell.
  • Wash your hands regularly with soap and hot water – do this for at least 20 seconds at each wash.
  • When you cough or sneeze, cover your mouth and nose with a tissue or your sleeve (not your hands). Immediately after use, put your used tissues in the bin and then wash your hands.
  • Do not touch your eyes, nose or mouth if your hands are not clean.
  • Do not share objects that touch your mouth, for example bottles or cups.
  • Do you best to follow all your medical advice on how to keep your condition well controlled.
  • Stay in regular contact with family, friends or neighbours as you may need to ask for help if you become sick.
  • Maintain a healthy diet – unless you have been advised to adhere to a specially prescribed diet, you should continue to try and eat a wide variety of foods that are rich in vitamins, minerals, fibre and other essential nutrients.
  • Try and engage in some form of exercise everyday – even if it is only walking up and down the stairs if you are able.

 

For Family and Caregivers:

  • Know what medications are prescribed – maintain a list.
  • Watch for new symptoms.
  • Prepare a plan to make sure food and other supplies are available when needed.
  • Consider options and have a plan for what would happen if you become ill.

 

International heart specialists are offering the following advice and opinion for specific heart conditions, says Croí

  • Individuals who are immunosuppressed, such as heart transplant patients or cancer patients who also have heart disease and pregnant women with underlying cardiac conditions are probably the most vulnerable to this virus and need to be extra vigilant.
  • There is no evidence to-date that the virus infects implanted devices such as pacemakers and cardioverter defibrillators or causes infective endocarditis (infection) in those with heart valve disease.
  • Individuals with Brugada Syndrome (heart rhythm disorder), need to be mindful of developing high temperatures (above 39 degrees Celsius) and should treat accordingly.
  • Individuals who have previously suffered from myocarditis or pericarditis are not at any higher risk of developing the same condition with COVID-19.
  • To-date there is no evidence that the coronavirus directly infects the heart however the infection caused by the virus may worsen heart function and exacerbate symptoms in patients with heart failure.
  • For the general population, wearing a mask is only recommended if you are experiencing symptoms or caring for someone with symptoms. If you have a heart condition, wearing a mask may make breathing more difficult so you should consult your doctor for advice on this.
  • All those with heart conditions who are on medications should take all their medications exactly as prescribed. Do not make any changes without firstly contacting your doctor or nurse.

Despite all the focus on coronavirus, the usual amount of heart attacks and strokes will continue to occur in our community. It’s important therefore to remind people not to delay if they are experiencing signs or symptoms of heart attack or stroke. If you do experience chest pains or stroke symptoms, please do not delay in calling 999 or 112. The emergency departments are still open for heart and stroke patients in all hospitals.

“While the Croí Heart & Stroke Centre is not currently running face to face classes or programmes, our health team are here as always to answer your questions so please don’t hesitate to reach out to us or visit our website for support resources,” says Irene Gibson, Director of Programmes.

 

You can contact the Croí Health Team on 091-544310 Monday – Friday from 9:00am – 5:30pm or you can email us at healthteam@croi.ie.

The Croí website (www.croi.ie) is regularly updated with the latest advice on COVID-19, along with practical guides and tips to help you achieve a healthy lifestyle.  

COVID-19: Advice for individuals living with Heart Failure

This advice is based on information from the Heart Failure Patient Council of the Global Heart Hub. Croí is a member of the Global Heart Hub.

Covid-19 presents the world with an unprecedented public health challenge. Its rapid spread has caused significant alarm and disruption across the globe. Understandably, those living with heart disease and heart failure are anxious and concerned.

It is well established that many virus infections can affect the heart, and experts suspect that coronavirus is no different. Viruses are known to induce inflammation of the myocardium (heart muscle). While in a healthy patient this may not lead to an adverse outcome, the situation for those living with heart disease and heart failure is different. Evidence suggests that if these individuals become infected with coronavirus they are at greater risk of adverse cardiac events and the outcomes may be poor.

COVID-19 is a new illness that can affect your lungs and airways. It’s caused by a virus called coronavirus. With the number of cases around the world increasing on a daily basis, hospitals are experiencing an unprecedented increase inpatient admissions. Consequently, hospitals are cancelling clinics and l non-urgent activity.  Only urgent and emergency cases are being treated to reduce the strain on staffing and beds, and prevent vulnerable patients being exposed to the COVID-19 virus unnecessarily.

It is important to remember that hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellations of appointments and disruption of services. The decisions on who will be treated will be based on clinical need, with those in most need of treatment being prioritised.

For further information on COVID-19 virus and symptoms see Croí’s advice here.

 

Staying well

For those living with Heart Failure:

  • Take all your medicines as advised by your doctor or nurse.
  • Do your best to follow all your medical advice on how to keep your condition well controlled.
  • Continue to self-monitor your condition and record your weight on a daily basis (first thing after you get out of bed in the morning).
  • Stay in regular contact with family, friends or neighbours as you may need to ask for help if you become sick.
  • Maintain a healthy diet – unless you have been advised to adhere to a specially prescribed diet, you should continue to try and eat a wide variety of foods that are rich in vitamins, minerals, fibre and other essential nutrients.

For Family and Caregivers:

  • Know what medications are prescribed and make sure supplies are secure.
  • Watch for new symptoms.
  • Prepare a plan to make sure food and other supplies are available when needed.
  • Consider options and have a plan for what would happen if you become ill.

 

What should I do if I experience gradual or persistent worsening symptoms of Heart Failure, such as my weight increasing or my legs swelling?

Self-monitoring of your condition on a daily basis is very important. It is equally important that you take your daily medicines as prescribed by your doctor.

If you experience any of the following worsening of symptoms, you should contact your GP, if available your Heart Failure Nurse or your local Heart Failure Clinic for advice and review of your medication. Due to the outbreak of COVID-19 many hospital staff have been redeployed. If you are unable to contact you heart failure nurse or team please contact your GP or local emergency department if you are concerned.

Worsening symptoms to look out for:

  • Weight increase greater than 3lb overnight or 5 lb (2kg) in a week .
  • Increased swelling in the legs or abdomen.
  • Increased shortness of breath on exertion, lying down or in bed at night.

If you have very sudden or very severe symptoms call for an ambulance so that you can be taken to hospital for treatment as soon as possible.

 

STAY CALM!

It is perfectly understandable that people may be feeling anxious or concerned about what might happen to them or their loved ones over the coming months. However, we must remind ourselves that this crisis will end. Only seek information from reliable sources – there is a huge amount of ‘fake news’ and false rumours which do nothing more than cause unnecessary anxiety and distress.

Already many heart patients are slow to respond to changes in their health or they are dismissing new symptoms because they do not wish to burden their doctor or local hospital. Despite the Covid-19 crisis, doctors and emergency rooms are still there to help heart patients so do not ignore worrying symptoms or delay in contacting them if you are unwell. Keep up to date with your local health information notices on how best to contact your GP or Heart Failure Nurse.  The Heart Failure Patient Council of the Global Heart Hub are being advised by medical and public health experts and we will keep you updated on any changes in information that could affect those living with Heart Failure.

 

See Croí’s health page for more information on heart failure.

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

COVID-19: Advice for individuals with Heart Valve Disease

People living with moderate or severe heart valve disease are at increased risk of complications if affected by COVID-19. Those at greatest risk are individuals with severe disease, significant ongoing symptoms or awaiting valve surgery.

It is important to remember that hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellations of appointments and disruption of services.

This advice is based on information from the Heart Valve Disease Patient Council of the Global Heart Hub. Croí is a member of the Global Heart Hub.

What should I do if I am due to have heart valve surgery or have a heart valve procedure?

If you are due to have surgery you should continue to prepare for it unless told otherwise by your clinician. If your surgery is rescheduled for a later date you should monitor your symptoms closely. If your symptoms get worse and you begin to feel unwell you should report this to your GP, call your hospital medical team or in severe cases, call the emergency services.

 

What should I do if I have recently had heart valve surgery or a heart valve procedure?

Patients who have recently had a procedure have an increased risk of infections due to cuts/incisions which may be exposed to germs. The normal risk of infection for heart valve disease patients is low, but in the current situation you should take every extra measure to limit your risk of infection. If you do begin to feel unwell you should contact your hospital medical team or call the emergency services.

 

How do I reduce my risk of contracting the COVID-19 virus:

There is currently no vaccine to prevent COVID-19 and the best way to prevent illness is to avoid being exposed to this virus. As you are at higher risk of a more serious illness if you contract coronavirus you are being advised to stay at home as much as possible and to limit your social contact.

We strongly urge you to take extra care in ensuring you follow all of the recommended precautions.

You need to be extra vigilant, be aware of your symptoms and take the recommended precautionary measures by physically distancing.

 

What are the symptoms of COVID-19?

For further information on COVID-19 virus and symptoms see Croí’s advice here.

If you are experiencing any of these symptoms and feel you need medical help, you should follow the guidelines issued by your health authority on how best to seek medical help.

Any heart valve patient with progressive or new onset symptoms, particularly syncope (fainting, ‘passing out’ or collapse) should contact their doctor immediately.

See Croí’s health page for more information on heart valve disease.

The Croí Health Team is here as always if you need support. Contact us by email at healthteam@croi.ie or call 091-544310.

Prioritise COVID-19 testing for patients with underlying conditions

The Irish Platform for Patients, Science and Industry (IPPOSI) calls on the HSE and GPs to prioritise COVID-19 testing for patients with underlying conditions and urges the public not to flood new testing centres unnecessarily.

Last week the HSE announced that it will be rolling out large scale Covid-19 testing throughout Ireland from Monday 16th March. The Irish Platform for Patients, Science and Industry (IPPOSI) says patients with underlying conditions want the HSE and GPs to prioritise testing for them, their families and carers. IPPOSI also calls on the public to act responsibly and not to flood new testing centres and GP surgeries unnecessarily with requests for testing.

Patients with chronic conditions are at particular risk of serious illness and death from COVID-19. It is essential that these people are diagnosed quickly and treated immediately and early testing for this community is essential.

Derick Mitchell, CEO of IPPOSI, urges the public to heed government advice on identifying the symptoms of COVID-19, namely having a cough and high temperature, and not to unnecessarily flood GPs and testing centres with requests for testing. “Our patient organisations tell us that their members our increasingly worried about accessing testing with many people self-isolating from family members already while they wait for access to testing.”

IPPOSI says that patients need advice that is targeted at the high risk and vulnerable groups rather than generic help line information currently available. Not only are high risk groups worried about contracting COVID-19 but they are also concerned about the impact on their regular treatments and medicines.  IPPOSI is calling for the following:

  • More streamlined and standardised communication process between the HSE, CHOs and Service Provider organisations as the situation escalates and regular services are impacted.
  • Dedicated contact points be identified within the Department of Health and HSE to ensure effective flow of information with patient organisations and to answer their concerns

IPPOSI also highlights the fact that information overload and false information is causing unnecessary worry and confusion amongst the High Risk Covid community. It urges members of the High Risk Covid community to follow the following guidelines:

  • The patient organisation for your specific disease should be your main information point. Patient organisations are open and are providing timely information updates for their communities regarding COVID-19.
  • Patient organisations are working with their respective clinical programmes and medical advisors in relation to condition-specific information of relevance to their members.
  • If you are worried about prescription medicines supply, please contact your local pharmacist for information. They are the experts in relation to supply of medicines.
  • IPPOSI as a partnership of patient organisations, science and industry is in an unique position to provide updated and reliable information through our Twitter account (@ipposi) & website ipposi.ie and we encourage people to follow these channels.

IPPOSI Chairperson, Ava Battles of MS Ireland added:

“We welcome the work of the National Public Health Emergency Team on COVID-19, in particular the engagement with patient groups and the subgroup for vulnerable people.  It is critical that these engagements provide leadership bringing clarity to the specific issues faced by both patient organisations and vulnerable groups and supports the roll-out of critical responses.

Croí is a proud member of IPPOSI.