By Ariel Chrysann
Special to the AFRO
Urgent treatment is needed for people experiencing a heart attack or stroke, but the act of stepping foot in a hospital in the age of COVID-19 sounds like a death sentence to most during this pandemic. Meet Dr. Wayne Batchelor, M.D., director of the Interventional Heart Program at Inova Health System in Fairfax, Va. He shared some important information with the AFRO to help settle the myths and calm fears.
AFRO: What type of doctor are you and how long have you been in healthcare?
Dr.Batchelor: I’m an interventional cardiologist. It’s a type of cardiologist who has particular expertise in intervening and treating coronary blockages and valve problems by opening up arteries and replacing valves. So we are sort of the invasive type of therapies that correct heart disease through different procedures.
AFRO: If an individual is experiencing symptoms of heart attack or stroke during the pandemic what are the necessary steps and precautions they should take?
Dr.Batchelor: That’s a very important question because what we’ve seen during the COVID-19 pandemic is a significant drop in the number of patients present in the hospital for heart attacks. We’ve seen a 38 percent reduction in admittance related to heart attacks. What we are seeing also is when patients do present, they tend to present worse off because of the delay for care, so the risk of dying or having a bad complication from a heart attack has gone up in part due to the COVID-19 pandemic.
Dr. Wayne Batchelor, M.D., director of the Interventional Heart Program at Inova Health System in Fairfax, Va. (Courtesy Photo)
Patients can typically look out for significant, new or different discomfort. It usually can be anywhere between their nose or the belly button. If you have discomfort it’s usually pressure, squeezing or heaviness that’s unrelenting. If it’s associated with shortness of breath, sweating, nausea or vomiting, and it doesn’t go away for about 20 minutes; that’s serious, do not stay at home, you have to be seen. Most of this (discomfort) is in the chest, but sometimes it’s in the shoulder blades or the arms, especially the upper arms. It can be in the top part of your stomach, jaw, chin area or your neck.
AFRO: How has COVID-19 changed the way people view hospitals and doctors offices, and what are things people should do before going to the hospital to reduce risk?
Dr.Batchelor: Studies have shown people are fearful of getting COVID-19, and there’s a sense that the hospitals are not safe yet. That is absolutely not the case. If you’re having a heart attack the best place for you to be is in the hospital. Hospitals, including Inova, have taken extreme measures to ensure the safety of patients and staff. As soon as you walk in the door social distancing is engaged, temperatures are taken and screenings are done at the entrance. All staff are wearing masks all the time in the hospital, and we are taking extra effort to test patients before any procedure to make sure we know whose COVID positive or negative. We’re trying to make sure all the COVID positive patients are not exposing any other staff or patients to infection. We have negative ventilation rooms, and I think we’ve done an extremely effective job of making hospitals safe for patients coming in with non-COVID problems.
I think it’s extremely important that patients understand, especially for those with heart disease, there are certain conditions of the heart where if you don’t get the medical attention needed you’re really exposing yourself to a higher risk of death or serious complications, and that risk is far greater than the risk of acquiring COVID-19. It’s extremely rare to get COVID-19 from a hospital or staff member. It’s also extremely rare for staff members to get it from patients.
AFRO: How do we get everyone to stop letting fear of the virus hold too much influence in life-threatening decisions?
Dr.Batchelor: I think it’s about public awareness and education. It’s difficult because there are so many sources of information. There’s a level of distrust, perhaps depending on what you’re listening to and the sources. We have to get back to the basics. People who are involved in healthcare: we live it, this is our life, this is what we study and this is what we’re experts in. Sources like physicians, nurses, administrators and hospitals, we know what’s going on. I think if we just got back to first principal and listen to information that’s coming from good sources we’d be further ahead.
It’s confusing for people because there’s so many different voices and non-experts talking about COVID-19. COVID-19 is a disease, and I think we should have the people who understand infectious diseases and treatments of the disease be the position of authority. I think that’s part of the problem. If we went in that direction we’d all be so much better, and people would have a good idea of what to do. It’s simple, wear a mask, social distance, utilize testing liberally and if you’re getting a procedure done many of us will recommend a test for specially invasive procedures. We just have to have a massive effort from the country in uniform because it’s the people who are asymptomatic who are continuing to be a pool of infection. We got to go after them, in my opinion from a systematic universal approach.
AFRO: What advice would you give to Black people who are disproportionately affected by the health disparity about trusting the healthcare system?
Dr.Batchelor: The Society for Cardiovascular Angiography & Interventions (SCAI) has started a public awareness campaign called Seconds Still Count. This is a really important campaign that’s allowing the public to understand the dynamic of what we are speaking about so that they can seek care properly in the event of a heart attack or stroke symptoms despite these fears. It started at the end of May and has continued. What we’re trying to do is allow patients to have the proper information and understand that their risk of dying or suffering severely from heart attack far outweighs that of dying of COVID.
We have to get this message out particularly to minority communities. Minorities are already disproportionately affected by COVID-19, in terms of cases and mortality rate, and unfortunately those same disparities are also for cardiovascular disease. So this interplay between COVID-19 and people not getting care out of fear or concerns of staying out of the hospital are also creating an unnecessarily bigger gap in outcome and disparities for minorities. This is a huge problem, adding insult to injury.
We’ve seen a substantial rise in the likelihood of dying over a heart attack simply from late presentation, that’s a phenomenon not only across the United States but the across world. I’ll give you an example, we’ll probably approach a range of 140,000 deaths from COVID-19, just to give you an idea. Cardiovascular disease annually kills over 400,000 people, so almost half a million people will die of some kind of cardiovascular disease over the next year. I’m not trying to downplay the importance or significance of the virus because this is a terrible pandemic, but the fear created from COVID-19 has added mortality to the number one cause of death in the United States, which is cardiovascular disease. COVID-19 is not only killing people but it’s also preventing them from getting good care for the other killer. Myself and various other professionals are trying to get ahead of this, and I applaud them for this Seconds Still Count Campaign.
AFRO: What are some things people can do while stuck in the house to reduce stress and prevent a heart attack or stroke?
Dr.Batchelor: There’s some low hanging fruit, no pun intended, but there’s some low hanging fruit at home that can really decrease stress and improve cardiovascular health. First off I would recommend a diet. We have a tendency to sit around and eat, lay down, watch tv or a movie; so we’ve got to try to engage in a healthier diet. I particularly like the mediterranean diet. There are lots of different diets out there but the meditteranean diet is complete in nutrition, and also has been shown to reduce heart disease. So think about what you’re eating and consuming; you are what you eat.
Get enough exercise. Exercise reduces stress, improves overall fitness and helps to ward off heart disease. So in terms of exercise, we’re talking about 150 minutes (about 15-20 minutes per day) of moderate exercise per week or 75 minutes of intense exercise per week. There are ways of doing that; walking outside briskly, treadmill (if you have access) or stairs, there are very safe, COVID-19 safe, ways of exercising.
Pay attention to your risk factors. If you smoke, stop; find anyway to quit. If you can reach out to physicians right now there’s adequate opportunity to have zoom and video visit sessions with physicians and other healthcare providers or counselors on smoking cessation techniques. I would work on that. I would work on making sure my blood pressure is well controlled. If you have high blood pressure and you can afford it, get a blood pressure cup. They’re not very expensive, and they fit on the upper arm between the elbow and shoulder. Check your blood pressure at home when you’re at rest, not excited but relaxed, create a log and communicate that information to whoever is treating you for your blood pressure. Reducing blood pressure reduces risk.
If you’re diabetic pay attention to your diabetes and understand what a hemoglobin A1c level is; which is a measurement of average blood sugar control. Make sure your hemoglobin A1c level is under control. Make sure you’re at a healthy body weight, getting lots of sleep and ensuring that your cholesterol is well controlled. It’s a long laundry list but most of these things we can do while engaging in social distancing and during quarantine to maintain cardiovascular health.
Lifestyle intervention reduces the risk by about 60 to 70 percent. We need to do it: eating, exercising, watching your weight, controlling blood pressure, smoking cessation and diabetes care. These are really important interventions that are far more effective overall than just waiting until you get heart disease and then thinking about your options.
These are great societies that have spent a lot of time gathering information you can trust;
- Society for Cardiovascular Angiography & Interventions (SCAI)
- American College of Cardiology
- American Heart Association
- The Association of Black Cardiologists
Remember if you experience symptoms of any kind related to heart attack, stroke or COVID-19 seek medical attention immediately because every second counts.