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Pandemic’s impact on heart health: ‘lower than expected’

The COVID-19 pandemic has taken a heavy toll – both directly and indirectly – on the nearly half of American adults who have some type of cardiovascular disease. 

Statistics suggest that in its early months, thousands who feared getting the virus in overcrowded emergency rooms may have died at home from heart attacks, especially in the most hard-hit states. Many others who put off seeing their doctors or undergoing needed procedures are now facing more invasive treatments and worse heart health outcomes as a result. 

Cardiovascular disease has also been established as a major risk factor for either having a more severe case of the virus or needing hospitalization. 

Then, there’s the impact of COVID-19 on the hearts of those who have already battled it. Ongoing problems with cardiac arrythmias, worsening heart failure, extreme fatigue and shortness of breath have been reported for some people well after they have recovered. 

However, BJC cardiologist Dr. Martin Schwarze, D.O. says the news about COVID-19 and heart health is not all discouraging. Schwarze reported that he and the other physicians in his practice have encountered a fairly low incidence of these types of heart problems in the COVID-19 patients they treat at Missouri Baptist Medical Center and other BJC hospitals.

“Early statistics hinted that heart complications could be frequent, but what I’m seeing and reading now is that it may be somewhere around 3% of COVID patients,” Schwarze said. “Although one of the big complaints (among hospitalized patients) is shortness of breath, when I’ve looked at those people I’ve been fortunate enough not to see very much heart damage yet … and my colleagues have reported the same thing. The biggest complications we are seeing are brain fog and fatigue, both in patients who have been hospitalized and those who recovered at home.

“The trick is to not get COVID, but if it happens there are certain things you need to watch out for, such as ‘happy hypoxia,’ where your blood oxygen level is low and you don’t realize it. You feel like everything’s OK, but your blood oxygen is in the mid-80s when it should be 95% or above.”

One definite positive emerging from the pandemic is that cardiologists and their patients are now fully embracing telehealth services for heart care, Schwarze said.

“During (telehealth) cardiology visits, we can see our patients, have them take their heart rate and blood pressure, and their families can also participate more easily. Obviously there’s not that physical touch element, but it has taken on a new dimension,” he said.

Newer types of wireless technologies that enable doctors to monitor patients’ heart rhythms for days, weeks, months or even longer via a simple patch worn on the chest or small device implanted under the skin are also making remote care more effective. In addition, telemedicine has allowed insurance companies to bill for interstate visits, giving more patients overall access to healthcare as well as expanding access for those with limited mobility and those who live in rural areas, Schwarze explained.

Schwarze’s main message to area residents is that it’s very safe to seek treatment for any heart-related symptoms, either in their physician’s offices or hospital emergency rooms.

“Be aware of how you feel. Don’t be afraid to come in and be evaluated, because we’ve gotten the (safety protocols) down in this COVID era … to make sure that patients can get in to see their physicians without any major risk of exposure,” he said. Those protocols – wearing masks, social distancing and frequent handwashing – really do work in preventing the virus, he added. 

While heart disease has long ranked as the No. 1 killer in the world, COVID-19 has now moved up to No. 2 – and the only other year that has ever happened was 1918, during the Spanish flu pandemic, Schwarze said. In the 1990s, when he served as president of the St. Louis Heart Association, cardiovascular deaths in the U.S. were starting to trend downward, “but now that trend has flattened out and started to creep back up.”

“So we need to remind people about the big things … like high blood pressure and high cholesterol … that can be addressed early on to prevent heart disease,” he said. “All these things are treatable … but you have to go in to see the physician to treat them.”

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