Mumbai hospitals witness 50% rise in emergency footfall of patients with heart attacks
Hospitals across the city are witnessing an almost 50% rise in emergency footfall of patients with heart attacks compared to the peak pandemic period in the second wave. This is attributed to sedentary lifestyle during the pandemic and disruption of treatment for patients with cardiac ailments in the lockdown.
Data from the state health department shows there has been a 27% drop in cases of hypertension and diabetes—which are considered as contributing factors to heart attack amid the pandemic compared to 2019-20. Doctors also believe Covid-19, which increases the chances of heart-related diseases, can also be a contributing factor. They lay emphasis on conducting more studies to conclude on the correlation.
Heart attack is the biggest killer in Mumbai. On an average, every day around 90 people die because of it, as per the data of Brihanmumbai Municipal Corporation (BMC). When the pandemic started in March 2020, both private and civic-run hospitals witnessed a drastic drop in cases of heart attack. But as the daily Covid-19 cases dip, there has been a sudden surge in cases of heart attack in the past 2-3 months.
Dr Akshay Deodhar, in-charge of accident and emergency department at Nanavati Max Super Speciality Hospital, that he has witnessed almost 50% rise in heart attack cases in the past few months. Wockhardt Hospital, Mira Road has recorded 8,451 cases of heart attacks since the start of the pandemic.
When the pandemic started, people refused to visit hospitals to avoid contracting Covid-19. Thus a large number of patients with diabetes and hypertension remained undetected or lagged behind in medication.
Data provided by the state health department shows that in 2019-20, a total of 173,678 patients were diagnosed with diabetes in Maharashtra, which dropped to 127,320 in 2020-21 amid the pandemic. Similarly, detection of patients with hypertension dropped from 230,476 to 166,968 in the time period in the state.
Dr Anup Taksande, consultant interventional cardiologist, Wockhardt Hospital, Mira Road, said, “Since Covid-19 cases started swelling up in the country, not many people were diagnosed with cardiovascular diseases as they failed to opt for cardiac screenings and seek timely intervention due to the fear of getting infected with the virus. Due to the lack of proper diagnosis, delayed treatment and complicated recovery, and ignorance, many suffered in silence. Still, many cases are going unreported. People have avoided treatment even after getting a heart attack.”
Dr Mohit Garg, consultant and head of accident and emergency at Global Hospital, Parel, stated that with the starting of the pandemic, all emergency visits and admissions across hospitals for heart related ailments had declined drastically by 40-50% compared with pre-pandemic data.
“Researchers concluded that people were more than twice as likely to die from a heart attack when compared with pre-pandemic times, probably because they were less likely to be hospitalized,” he said.
Covid-19 a cause?
Studies across the globe have stated that Covid-19 recovered patients are vulnerable to developing heart attacks within two-three weeks of recovery. A study—Incidence and clinical profile of acute coronary syndromes (heart attacks) in recovered cases of Covid infection – by doctors from Sri Jayadevai Institute of Cardiovascular Sciences and Research, Bangalore in June found that 26 patients who recovered from Covid-19 had suffered a heart attack within seven to eight weeks of post recovery.
“There is a widespread swelling (inflammation) as the body’s immune system fights the infection. The inflammation not only affects the lungs, but also the heart, brain, kidneys and other systems of the body. We also know that the Delta variant can have more effects. Many patients have been experiencing cardiac symptoms during the pandemic,” said Dr Ruchit Shah, interventional cardiologist, Masina Hospital.
A study published in the Lancet which was conducted among 86,742 people found that the risk of heart attacks and strokes is three times higher in the first two weeks of Covid-19 infection.
Dr Garg also shared the same opinion. “In various studies over the past few months, it has been found that Covid-19 evolved as a major risk factor for heart attacks and strokes. It is fatally affecting a large number of young people with no pre-existing heart ailments or any traditional risk factors such as diabetes, hypertension or high cholesterol,” he said.
Doctors are getting several patients with complaints of chest pain who upon diagnosis are identified as Covid-19 positive. “As per our safety protocol, every patient strictly undergoes a Rapid Antigen test (RAT), followed by an RT-PCR test. We diagnosed active Covid-19 infection in less than 4% to 5% of patients, who rushed to the casualty ward,” said Deodhar.
Many young people between the age of 20 and 35 years are getting diagnosed with heart attacks.
Dr Taksande said he is witnessing a large number of patients in emergency between the age of 20 to 35 years suffering a massive heart attack and succumbing to it.
Doctors have recommended social distancing, avoiding crowded places, double masks covering nose and mouth, sanitization and complete vaccination as must for all. Dr Shah further recommended avoiding heavy strenuous activity for six to eight weeks after Covid-19 infection.
Tushar Rane and Sanchita Gamre, a ward boy and technician from Nanavati Max Hospital, gave a new lease of life to a 55-year-old heart attack patient by providing him Cardiopulmonary resuscitation (CPR) in an autorickshaw while ferrying him to the hospital.
CPR is a lifesaving technique that involves chest compressions in an effort to manually help in breathing of a person who is in cardiac arrest.
On September 20, when the two staff visited a nationalised insurance company for personal work, they witnessed the man collapse. “I had barely climbed the stairs when I heard my colleague Sanchita calling out my name loudly,” said Rane. “He was breathless and had no pulse. I immediately started CPR,” said Gamre who works as a senior technician in the 2D Echo unit.
The patient’s angiography revealed a 100% blockage in the patient’s left anterior descending artery (LAD)—the largest and most important of the three main coronary arteries. Cardiologists from the hospital immediately performed an angioplasty to relieve the block and restored the heart’s blood flow. The patient was discharged within 48 hours of observation.