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Post-COVID heart disease fears

Posted 4 May 2020

Specialists are bracing for a potential wave of non-coronavirus illnesses such as cardiovascular disease and other serious conditions as patient numbers at Emergency Departments plummet and pathology tests fall dramatically.

In an article published today (Monday) in the Medical Journal of Australia's InSight+, Australian doctors have relayed their concerns that many conditions are going undiagnosed.

Alfred Health interventional cardiologist and Ambulance Victoria medical advisor associate professor Dion Stub said initial data indicated a 30 per cent drop in triple-0 calls for chest pain in Victoria in recent weeks.

"There is definitely a sense across Victorian hospitals that emergent cardiac work for patients with both ST elevated myocardial infarction (STEMI) and non-STEMI heart attacks is significantly reduced," Stub said.

"Whether it's by 20 per cent or 40 per cent is hard to definitely say at this stage, but it's looking to be significant proportions."

Stub said there was no obvious explanation for the drop "apart from the real possibility that patients are avoiding coming to hospital, they are not seeing their cardiologist and they are potentially afraid even to see their GPs".

Australasian College for Emergency Medicine president Dr John Bonning noted in the article the substantial reduction in ED presentations across Australia, with data suggesting declines of up to 30 per cent.

He said the UK had reported patients presenting late with bowel conditions, sepsis, appendicitis and chest pain, with anecdotes of similar late presentations already happening in Australia.

"We are worried that attendances for some major problems appear to have decreased, things like heart attacks and strokes and major sepsis conditions and also people with complications from cancer and immunological diseases, or people who have transplants and are immunocompromised," he said.

Dramatic falls in the uptake of other healthcare services have also fuelled concerns that patients are delaying tests and treatments for fear of COVID-19 infection or facing an overwhelmed health system.

Royal College of Pathologists of Australasia (RCPA) president Dr Michael Dray said between 30 and 40 per cent of private and community pathology testing was not being done due to people not visiting their medical practitioner and not having their pathology samples collected.

"This equates to over 60,000 Australians every day, with a similar proportion of patients in New Zealand too," he said.

Megan Brodie

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