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Don’t ignore heart and stroke symptoms: in the midst of COVID-19, your health system is here to care for you

Even during a global pandemic like COVID-19, it is important to remember that when a heart attack or stroke occurs, getting the right care fast is critical.
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People experiencing heart attacks and strokes should call 9-1-1 immediately – even during the COVID-19 pandemic.
This urgent call from the Canadian Cardiovascular Society, the Canadian Stroke Best Practices Advisory Council and multiple reports from the front lines of hospitals around the world indicate a drop in the number of heart attack and stroke emergency room admissions.

“Due to our current pandemic, many people may think the hospital is the last place they should visit, even though they may be having symptoms of chest pain or shortness of breath,” said Dr. Sean Virani. “However, delaying access to clinical care can be life threatening or life altering.”

The consequences of delaying critical care

Even during a global pandemic like COVID-19, it is important to remember that when a heart attack or stroke occurs, getting the right care fast is critical. Each minute without oxygen and blood flow to the brain or heart increases the risk of permanent damage and death. Every second counts.

In British Columbia, Cardiac Services BCStroke Services BC and BC Emergency Health Services have identified a significantly lower volume of critical cardiovascular presentations and subsequent interventions when comparing January – April 2019 with the same period in 2020.

“This year we’ve noticed a decline in people presenting with stroke, cardiac arrest and heart attack for emergency care,” added Dr. Virani. “This is distressing as we have no evidence that indicates that fewer heart attacks or strokes are happening in our province compared to last year.”
Cardiac Services BC noted a drop in treatments for ST-elevation myocardial infarction (STEMI), a very serious type of heart attack where there is a complete blockage of blood flow in a coronary artery supplying the heart with oxygen-rich blood. This decrease is consistent with drops in coronary revascularization treatments like percutaneous coronary intervention (PCI) and other treatment methods like fibrinolysis.

According to the Heart & Stroke Foundation:
  • Each year, an estimated 35,000 cardiac arrests occur in Canada. The vast majority happen in public places or at home, and few people survive. But survival rates double if someone performs CPR and uses an automated external defibrillator (AED).
  • Each year in Canada, 62,000 strokes occur. It’s a leading cause of death and a major cause of disability. Strokes have a devastating impact on Canadian families, and can change lives in a second.
heart attack, or myocardial infarction (MI), occurs when blood flow is reduced or stops to a part of the heart muscle. If not promptly treated, this disruption in blood flow can cause damage to the heart muscle or be fatal. The national target for cardiologists in Canada is to initiate treatment within 2 hours of first medical contact and to complete treatment within 12 hours of symptom onset. Time is of the essence and seeking rapid medical attention is critical.

Without immediate help, a victim of sudden cardiac arrest suffers brain damage within three minutes. After 12 minutes, survival is unlikely. Evidence shows that when cardiopulmonary resuscitation (CPR) and automated external defibrillators (AED) are used together in the first few minutes during a sudden cardiac arrest, survival rates can be doubled. 

stroke is a disruption of blood supply to the brain – either through a blockage due to clot (ischemic), or bleeding (hemorrhagic). The amount of brain affected by the stroke and the type of symptoms a person would experience depends on where the blockage or bleed occurs. In both cases, if the blood supply is not restored quickly, the affected part of the brain dies, causing disability or death.

Signs to look out for

Signs of a heart attack can vary and may be different for men and women. If you experience any of these signs, call 9-1-1 or your local emergency number immediately:



  • Chest discomfort (pressure, squeezing, fullness or pain, burning or heaviness)
  • Sweating
  • Upper body discomfort (neck, jaw, shoulder, arms, back)
  • Nausea
  • Shortness of breath
  • Light-headedness
If the heart stops for any reason, blood is no longer getting to the brain, heart and vital organs, you may be suffering a cardiac arrest. Death can occur within minutes. Signs of a cardiac arrest include:


  • Sudden collapse
  • Unresponsive to touch and sound
  • Not breathing or is making gasping sounds 
Strokes and transient ischemic attacks (TIA) are medical emergencies. Knowing the signs of stroke and acting quickly can improve your chances of survival and recovery.
 
Think FAST when you think you or someone you’re with is experiencing a stroke:


Remember:

  • Symptoms of stroke come on suddenly, usually without any warning at all.
  • Even signs of stroke that only last for a short period of time and then disappear require emergency attention.
  • Denial of stroke symptoms is common but stroke is treatable and immediate medical attention is critical to recovery.
  • Stroke can happen at any age so don’t assume that just because a person is young or otherwise healthy that their symptoms couldn’t be a stroke.
  • A TIA can be considered a “mini-stroke”, when blood flow to the brain stops for a short period of time. A TIA is an important sign of a problem with blood flow to the brain and should be treated as an emergency.

The bottom line

From dispatchers to first responders and emergency departments at hospitals, the emergency response system is trained to help you safely and quickly, even during a pandemic.

Don’t delay your care, if you identify signs of heart attack or stroke on yourself or anyone around you, remember:
  • Calling 911 immediately is still your best chance of surviving or saving a life.
  • It is SAFE for ANYONE to go to the hospital.
BC Ambulance Service; BCEHS; Cardiac Services BC; heart conditions; hospital admissions; Stroke Services BC
Research
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