Abu Dhabi: Amidst the COVID-19 pandemic, a large number of people experiencing chest pain are continuing to delay medical care at their own risk.
The European Society of Cardiology (ESC) found in a 141-country study published in June that the number of heart attack patients seeking urgent hospital care has dropped by more than 50 per cent during the COVID-19 outbreak. On World Heart Day today, doctors have therefore urged patients to seek medical attention as soon as they face cardiac symptoms.
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Increased cardiac mortality
“A delay in seeking treatment has proved fatal for many cardiac and oncology patients during the COVID-19 period. Studies have found that patients are worried about contracting the coronavirus at the hospital, and this has increased cardiac emergency mortality worldwide,” said Dr Walid Shaker, cardiothoracic surgeon at Burjeel Hospital Abu Dhabi. The ESC has also revealed that patients who do not present themselves promptly are in a far worse condition when they finally arrive at hospital, and they are often too late to benefit from life-saving treatments that can be provided. “The fact remains that hospitals remain extremely safe places for patients, and medical care is imperative for cardiac patients,” Dr Shaker urged.
The doctor detailed the miraculous case of a 25-year-old man who had come to the hospital eight days after first experiencing chest pain. Muhammad Arshad, a Pakistani teacher, had first started feeling unwell on September 7, but chose to wait. A week later, his chest pain had worsened so much that he finally decided to go to a hospital. “The doctor at the hospital performed a few tests, and he said it is a cardiac problem. They told me that I have to conduct advanced tests at a multi-speciality facility for further clarity on my health condition. I stayed at the hospital for a day. On the second day, it had become difficult for me to raise my left arm, so I was transferred to Burjeel Hospital,” Arshad said.
Major vessel tear
By the time Arshad reached Burjeel, his condition had deteriorated further, and he was partially unconscious. “We found that his aorta, the main blood vessel supplying blood to the body, had a major tear, creating a false lumen through which the blood was flowing. The valves in the vessel had also been damaged, causing acute backflow to the heart and preventing the organ from functioning normally. In addition, the branches of the aorta supplying the brain had also been impacted,” Dr Shaker said.
Lucky to survive
“The patient was lucky to survive the week. In most other cases, such a cardiac incident would have resulted in sudden death. In addition, such delays can also lead to permanent damage to the heart and other organs,” the doctor added.
Arshad reached Burjeel at 6AM on September 16. Two hours later, a 10-person team began the complex procedure of repairing his aorta. An artificial tube was inserted to replace the aorta, and the aortic valves were also constructed. The vessels leading to the brain were the implanted to the arch of the new tube. The procedure took a total of 22 hours to complete.
“This is the kind of case where you would normally hear of sudden death. But Arshad is young and otherwise healthy, and he is recovering well. In fact, if he had come in earlier, he may not have experienced neurological manifestations like the paralysis. In contrast, for an older patient in his 50s, this kind of delay would have been fatal,” Dr Shaker said.
The doctor explained that Arshad was diagnosed with Marfan syndrome, a genetic disorder that affects the connective tissue of the body, and causes them to be fragile. The patient is still hospitalised at Burjeel’s Intensive Care Unit, but is expected to be discharged in a few days. Dr Shaker added that he will have to be in complete rest for about two more months, even though he is able to walk, eat and talk normally even now.
“I was very scared. I vividly remember the words of the doctor that they are taking me for surgery and I will be all right. I am better now, and am thankful to Allah for His kindness, and the medical team at the hospital for taking care of me,” Arshad said.
Apart from seeking medical care on time, residents also need to make lifestyle changes for heart health. After all, cardiovascular diseases remain the UAE’s top killer, accounting for two-thirds of all deaths in the country. The major factors for cardiovascular illnesses are also still highly prevalent among the population, including diabetes, which affects one in every five adults, obesity, metabolic disease, stress, genetic risks and smoking.
But positive change is not unthinkable, and requires effort by every individual, said Rahim Ullah, a 52-year-old office worker from Bangladesh. Rahim Ullah suffered a cardiac arrest in September 2018, and Dr Jose John, specialist cardiologist at LLH Hospital Musaffah said he was miraculously revived after prolonged cardiopulmonary resuscitation. “He underwent a successful angioplasty, and is now a completely reformed man, meticulously following a healthy lifestyle,” the doctor said.
Rahim Ullah gave up smoking right after this episode, even though he had been smoking more than a pack of cigarettes a day for more than three decades. “I would smoke a lot, but when the doctor told me I had to give it up, I quit cold turkey. I also stopped eating beef, and began eating on time so I don’t end up overeating,” he said.
Rahim Ullah also began going for 30 to 40-minute walks every day, a habit he has continued amid the COVID-19 outbreak. “My doctor told me I had to take care, so I did what I had to, and I hope it will keep me healthy and safe. My wife and three children back home are certainly very happy to know I am taking care of my heart and health,” he said.