Cardiovascular care in the time of COVID-19

By Gregory Katz, MD  |  6/18/2020

It’s astounding to think about how much COVID-19 has changed our lives since the beginning of the pandemic. Almost every aspect of normal life has been disrupted, and this has been felt as deeply in the medical system as anywhere else. But at The Heart Center, a division of Hudson Valley Cardiovascular Practice, P.C., now part of Nuvance Health, we’ve been adapting our practices to take care of our patients’ cardiovascular health despite the challenges the pandemic has brought us.

Cardiovascular disease didn’t take a break because of COVID-19

Unlike social gatherings, we can’t just hit pause on cardiovascular disease. Our patients with heart disease don’t get a respite from their medical issues just because it’s a pandemic. It has been widely reported that people with older age and cardiac risk factors like hypertension and diabetes appear to be at a higher risk of developing more serious complications from COVID-19. Research has shown these are the people who have been staying at home.

On the one hand, this is a good thing — staying at home means less spread of the virus. But on the other hand, it’s meant that vulnerable patients who have real medical needs have gaps in their care. Consequently, many patients skip necessary medical care for a disease we know they already have because of the fear of a disease they might get.

We’re seeing patients stay home despite worsening congestive heart failure.

We’re seeing patients wait out a heart attack on the couch instead of coming to the emergency room.

We’re seeing patients with uncontrolled atrial fibrillation suffer with shortness of breath and palpitations instead of coming into the office to be evaluated and treated.

The gaps in care caused by COVID-19 are worrisome and underscore just how fragile our health can be if we are forced to forego important medical care.

Postponing procedures

As our hospitals focused on the care of COVID-19 patients, we were forced to delay many procedures considered “elective.” Unfortunately, elective in cardiology typically does not mean it’s not essential. These include fixing a severely tight aortic valve to relieve symptoms of congestive heart failure, opening a blocked artery to treat intractable chest pain and conducting transesophageal echocardiograms to find blood clots and diagnose critically leaky valves.

COVID-19 has limited our ability to perform the necessary work we’ve needed for many patients resulting in people suffering at home. Fortunately, we’ve been hard at work getting our catheterization laboratories opened so we can treat our patients who are dealing with cardiovascular disease.

Implementing telehealth

Throughout the pandemic, we’ve been using Virtual Visits to treat our patients. It’s been a learning curve for the patients and for the doctors. While we can’t perform a true physical exam, we can do things like monitor a person’s breathing and blood pressure, make medication adjustments and check in frequently to see the effects of our treatments.

Telehealth has helped us bridge the massive gap that would otherwise exist in the time of COVID-19. While we’ve had to figure out a way to make it work, having the opportunity to “see” our patients with a Virtual Visit has certainly enabled opportunities that have kept our patients out of the hospital.

Opening our offices, testing and treatments

As we have learned more about COVID-19, we’ve also learned more about safety practices. With masking, hand washing and surface decontamination, we’ve been able to open our catheterization lab, restart our valve program and get our patients into the office for in-person follow-ups.

If you’re a Heart Center patient, you can feel confident that we are employing practices to keep patients and staff as safe as possible.

The most important lesson we’ve learned from COVID-19, is cardiac problems can’t be turned on and off. I encourage all our patients to seek medical care if you’re feeling unwell. Both in the office and at the hospital, we’re protecting our patients from getting sick with the tools at our disposal.

Please don’t stay home with an untreated and potentially unstable heart problem because you’re worried about COVID-19. If you’re experiencing palpitations, chest pain, shortness of breath or chest tightness, you should come in to get checked out.

The COVID-19 pandemic has forced us all to take stock of how we approach cardiovascular care. We’ve learned a lot about what we can manage over the phone and out of the hospital — and what we can’t manage without an in-person visit.

We will continue to adapt with the times to ensure our patients get excellent cardiovascular care.

For more information on cardiovascular care and The Heart Center, visit www.nuvancehealth.org/heartcenter