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.