TGH doctor says don’t let pandemic stop you from going to emergency room if you have cardiac symptoms

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This illustration, created at the Centers for Disease Control and Prevention (CDC), reveals ultrastructural morphology exhibited by coronaviruses. Note the spikes that adorn the outer surface of the virus, which impart the look of a corona surrounding the virion, when viewed electron microscopically. In this view, the protein particles E, S, and M, also located on the outer surface of the particle, have all been labeled as well. A novel coronavirus, named Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), was identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China in 2019. The illness caused by this virus has been named coronavirus disease 2019 (COVID-19).

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Many hospitals are seeing a drop in the number of stroke and heart attack patients showing up in emergency rooms since the beginning of the COVID-19 pandemic. But a doctor from Tampa General Hospital says it’s much safer to come to the emergency room than not if you’re having serious cardiac symptoms or any other medical emergency.

Dr. Fadi Matar is director of the cardiac catheterization laboratory at TGH and an associate professor of medicine at the University of South Florida.

“We have seen a significant drop in the number of patients presenting to us, for myself with heart attacks. That’s what I deal with. So there was a drop of those visits to the emergency room. And actually that is similar to other hospitals in the nation and we’ve been in contact with our colleagues throughout the nation and they have similar experiences. And that was intriguing to us. We think that the reason for that is the fear factor, from patients not wanting to show up to the emergency room with this.”

How can a patient tell if their condition is serious enough that they should take the risk — if there is a risk — take the risk of going to the hospital or to the emergency room in order to get help?

“As far as cardiac symptoms, if somebody feels chest heaviness, pressure in the chest — does not have to be pain, especially if along with that they feel ill, short of breath, they feel sweaty, nauseous, they look pale or their heart is too fast, or too slow or lightheaded.

“These are all signs that there is something concerning happening and that they should be careful about it and not delay. Because if that’s happening the chance of them having a bad outcome because of that is much higher than the chances of them contracting COVID if they go to the hospital.

“These days the hospitals are well — the patients are well-screened and all the precautions are taken in the hospital. They should not delay especially if any of those symptoms happen.”

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So what I think I hear you saying is that if a patient is going to an emergency room especially here in the Tampa Bay area it’s very safe for them. It’s very unlikely they would become sick from that?

“That is correct. We always have to weigh the benefit and the risk of anything we do in medicine. So given the relatively low prevalence of COVID in the Tampa Bay area and given the fact that hospitals have a lot of good precautions and screening methods and isolation and distancing.

“With all those factors being taken into account the risk of COVID-19 related issue, if you show up to the emergency room or to your physician’s office, versus the risk of staying home and not doing anything if you have those symptoms, obviously you have the risk balance ratio favors you showing up.”

You have COVID-19 patients at Tampa General Hospital right now. That might not be your area — but what can you tell us about their conditions and how they’re isolated in the hospital?

“We do have separate units. We call them COVID units. They are separated with all the precautions from the rest of the hospital.

“I have not checked on the status of them in the past few days, but we have a daily briefing. So far I think the maximum we’ve gotten at Tampa General is, like, 12 at a time in that unit and maybe one or two on a ventilator.

“We have had very good outcomes with those patients. Even if they were on a ventilator many of them came off the ventilators and did well.

“So our experience at Tampa General has been very favorable, and we have all the precautions. We all wear masks when we are there seeing patients or walking in the hallways. We always do all the necessary precautions with distancing. We follow all the rules in the hospital so patients should feel safe in the hospital.”

Dr. Matar, those were my questions. Is there anything else that people should know about medicine in the time of coronavirus?

“It’s very important that our patients, especially those who are known to have heart disease or cardiovascular disease, to take those as seriously as the COVID-19.

“Don’t ignore your health. Do not ignore your symptoms because the chance that you can have trouble from that if you ignore them is much higher than the chance of you contracting COVID-19.

“Especially that we are living in Tampa Bay, which is not New York, not New Jersey. We don’t have the prevalence, thank God, of this. So keep that in the back of your mind. Do not prevent yourself from benefiting from medical therapy just because of the perceived fear.

“I’ve seen several patients who presented late, after having a heart attack. They did not go to the emergency room and then two of them died because of the complications of the heart attack that happened while they were still at home. They showed up too late. They were in cardiogenic shock and died. So that’s my advice.”

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