By Vincent Spagnuolo, MD, FACC, Virtua Health Cardiologist, Lead Physician, Virtua Cardiology—North

Up until a few months ago, if you were experiencing chest pain or shortness of breath—two classic signs of a heart attack—it would be a no-brainer. You would call 911 and head to the nearest hospital emergency room.

But with hospitals across the U.S. focused on caring for patients with COVID-19, people with urgent health problems like heart attack or stroke are delaying or skipping visiting the ER for fear of catching coronavirus in the hospital, not receiving treatment, or being isolated from loved ones. 

A recent study published in the Journal of the American College of Cardiology, noted that each of the nation’s nine largest hospitals have seen a dramatic drop in heart attack patients, including a 38 percent reduction in emergency cardiac catheterization procedures.

The decision to forego treatment can have significant consequences to your health and well-being.

Every minute counts

A heart attack occurs when blood flow to the heart is severely reduced, or cut off completely. The amount of damage to the heart muscle depends on the size of the area supplied by the blocked artery and the time between injury and treatment.

About 85 percent of harm takes place within the first hour. This is often referred to as the “golden hour,” the timeframe that heart damage can be minimized if blood flow is restored. If the vessel isn't reopened, parts of the heart may be permanently injured. About 10 percent of heart attacks are fatal.

A stroke occurs when the blood supply to the brain is blocked. As with a heart attack, the longer it takes to receive emergency treatment—such as drugs to dissolve the clot or a minimally invasive procedure to remove it—the more brain tissue dies and the worse your outcome will be.

If you or a loved one experiences symptoms of a heart attack or stroke, it's important to get to the emergency department quickly for evaluation and treatment.

Know the signs

A key message in reducing the spread of COVID-19 has been to stay at home. However, you can’t treat a heart attack or stroke yourself at home.

Common heart attack symptoms include:

• Pressure, tightness, pain, or a squeezing or aching sensation in your chest or arms that may spread to your neck, jaw or back
• Nausea, indigestion, heartburn, or abdominal pain
• Shortness of breath
• Cold sweat
• Fatigue
• Lightheadedness or sudden dizziness

Symptoms of a stroke include:

• Sudden numbness or weakness in the face, arm, or leg
• Confusion, trouble speaking or understanding
• Trouble seeing in one or both eyes
• Trouble walking, dizziness, loss of balance, or coordination
• Severe headache with no known cause

Two of the more serious symptoms of heart attack, chest pain and shortness of breath, overlap with those of COVID-19. Regardless of whether your breathing trouble or chest pain is caused by a heart attack or the virus, get to the hospital. It could save your life.

Protecting your health

While people with heart disease are more vulnerable to developing severe forms of COVID, hospitals have taken steps to protect patients from exposure to COVID. These include separate screening, triage and isolation areas and masking of patients and staff.

Thanks to these and other precautions, our doctors and nurses remain fully equipped to treat all patients with acute issues. There’s no reason to fear coming to the hospital for treatment.

To further help reduce your risk for catching COVID-19, follow these precautions and social distancing guidelines: 

• Obey state stay-at-home orders.
• When in the community, stay at least 6 feet away from others.
• Use Skype, FaceTime or other video apps to stay in touch with family and friends. 
• Avoid close contact with people who are sick.
• Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
• If soap and water are not available, use a hand sanitizer with at least 60 percent alcohol. Always use soap and water if your hands are visibly dirty.
• Avoid touching your eyes, nose, and mouth.
• Cover your cough or sneeze with a tissue, then throw it in the trash.
• Clean and disinfect frequently touched objects and surfaces with a household disinfectant.
• Maintain healthy habits, like eating well, getting enough sleep and managing your stress levels.
• Take advantage of video appointments with your doctor using secure “telehealth” technology. This allows you to stay in close touch with your doctor, eliminates the need for close interaction with medical personnel, and helps reduce your risk for exposure.
• Don't stop any medication unless directed by your doctor.