Amid the Coronavirus Disaster, Coronary heart and Stroke Sufferers Go Lacking


Bishnu Virachan was a bicycle supplier for a grocery store in Queens. When New York City was closed, he was busier than ever.

But in early April, when he was watching TV, he felt "a pain in my heart". It startled him, but he didn't go to the emergency room. Mr. Virachan, 43, was even more afraid of it.

"What can I do? What can I do? "He asked." The coronavirus everywhere. "

After a few days, the pain overcame the fear and he went to Mount Sinai Hospital in Manhattan. Doctors discovered an almost complete blockage of his left main coronary artery .

A surgeon opened the artery, but Mr. Virachan had a weak heart. If he had waited much longer, doctors said he would have died.

The fear of the corona virus causes people Staying at home with life-threatening emergencies, such as a heart attack or stroke, when they would normally be in a hurry, suggests preliminary research. Without immediate treatment, some patients, such as Mr. Virachan, have suffered permanent damage or have died.

have emergency rooms About half the normal number of patients, and heart and stroke units, according to doctors of almost empty, are many urban medisans Centers Some medical experts fear that more people will die from untreated emergencies than from the corona virus.

A recently published paper by cardiologists in nine major medical centers estimated the number of patients with severe heart attacks by 38 percent since March 1, urgently needed procedures to open their arteries.

One day at the Cleveland Clinic, there were only seven patients in the 24-bed coronary ward. Usually the unit is full.

"Where are the patients?" Asked Dr. Steven Nissen, a cardiologist there. "It cannot be normal."

One of the few was a man who lives in Cleveland. According to Dr. The man felt pain in the chest while doing push-ups, but was afraid to go to the hospital because there might be coronavirus patients living there. He stayed at home for a week and became weaker – breathless with the least effort, his legs swollen. Finally, on April 16, he went to the Cleveland Clinic.

What should have been an easy-to-treat heart attack had developed into a life-threatening disaster. He survived after delicate surgery and spent almost a week in intensive care, including several days on a ventilator, said Dr. Nits.

The inpatient stroke ward at Stanford University Medical Center in California typically has 12 to 15 patients, said its director, Dr. Gregory Albers. On a last day in April there was none at all that had never happened before.

"It's terrifying," said Dr. Albers. However, only a few Covid 19 patients have been hospitalized, and people who need emergency treatment have little to fear.

"We were preparing for an attack, but it didn't arrive," said Dr. Albers.

According to Dr. Samin Sharma, director of the cardiac catheterization laboratory at Mount Sinai Hospital in New York, saw the number of heart attack patients drop from seven in February to three in March. So far there have only been two in April.

It is not just the United States. Dr. Valentin Fuster, editor of the Journal of American College of Cardiology, said he gets so many articles from all over the world about the sharp decline in heart attack patients in hospitals that he simply cannot publish them all.

A hospital in Jaipur, India, which Dr. Sharma owns treated 45 heart attack patients in January, he said. In February there were 32 and in March 12. In April, there were only six.

"I am very, very concerned that we are creating a problem that will have long term ramifications for community health," said Dr. Richard A. Chazal, medical director of Lee Health's Cardiovascular Institute in Fort Myers, Florida, and former president of the American College of Cardiology.

Could it be that there are actually fewer medical emergencies now? Dr. Fuster speculated that people may be healthier because they eat better, exercise more, and have less stress now that so many work from home. And of course the air is cleaner in urban areas.

Other experts doubt that better health habits could have such a dramatic and immediate impact. Far from eating better, said Dr. Nits, many patients tell him that they eat too much comfort food. There is no evidence that people exercise more and are less stressed.

"You are scared to death," said Dr. Nits.

And he said even if some people have changed their habits. Studies have found no immediate effects of short-term lifestyle changes on the heart attack rate.

At the moment it is almost impossible to know who is not in emergency rooms. and why, said Dr. Harlan Krumholz, cardiologist at Yale University. "You can't find the dog that doesn't bark," he said.

But you can get a feeling from the patients who show up late.

Kaplana Jain, 60, from Cresskill, New Jersey, watched CNN late in the evening of April 18. She got up to go to the bathroom and fell to the floor. Her blood sugar was high and her family called 911.

When the paramedics arrived, Ms. Jain told them that she did not want to go to the hospital. "I was afraid of the corona virus," she said.

The next day she called Dr. Sharma, a family friend. He urged her to go to the hospital, but she still insisted on going to his office the next day.

When she arrived, Dr. Sharma received an EKG that confirmed that she had a heart attack. He took her to the hospital and opened a blocked artery.

"She is one of the lucky people with this type of heart attack who has not developed cardiac arrest or has suffered a shock," he said. If she hadn't gone to the hospital, she would probably have died at home.

Back at the Cleveland Clinic on April 15, a man with stroke symptoms arrived. According to Dr. Thomas Waters, an emergency doctor, The man had waited two days because he was afraid of the corona virus. There was nothing doctors could do to prevent permanent brain damage.

"What is done is done," said Dr. Waters. "Now we have reached a point where we have nothing more to offer than rehab."


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