Concern over ‘excess’ heart problem deaths during coronavirus pandemic

There has been a "concerning" rise in the number of under-65s dying from heart problems as a consequence of the coronavirus pandemic, a leading charity has warned.

The British Heart Foundation (BHF) said there has been a worrying rise in additional deaths from heart and circulatory diseases.

It urged people to seek medical help if they had any troubling symptoms.

The charity also said that maintaining cardiac services during a second peak of the pandemic should be a "priority" as delaying care for heart and circulatory problems can cause "avoidable harm".

It said that the number of excess deaths could rise as the NHS faces the second surge of Covid-19 cases and usual winter pressures.

The charity has calculated that in the under-65s alone there has been more than 800 "excess" deaths from heart and circulatory problems since the start of the pandemic.

It analysed official mortality data for England and Wales to examine the number of deaths among heart patients, especially among those aged 65 and under.

It said that during the first peak of the pandemic there were almost 2,800 deaths in the under-65s where the underlying causes were heart and circulatory diseases – around 420 more deaths than expected for that period of the year.

Then between May and July almost 3,100 deaths were registered in this group – around 350 more deaths than expected for that period of the year.

There were no excess deaths seen in this group between January and March, the BHF added.

"We know there are tragic consequences of the pandemic for patients with heart and circulatory diseases, and these figures further highlight that delays in care are likely contributing to more deaths than we would expect to see otherwise," said BHF associate medical director Dr Sonya Babu-Narayan.

"It's particularly concerning that we are seeing this trend in people under 65 continue even after the first peak of the pandemic.

"Despite rising cases of Covid-19, restoring and maintaining planned cardiovascular care must remain a priority. Over time, heart and circulatory problems can become more urgent and delaying this care could risk avoidable harm.

"It's also vitally important that people don't let the fear of catching coronavirus put them off seeking medical help.

"If you think you are having a heart attack or stroke call 999 immediately – every minute matters and prompt treatment saves lives. If you have been waiting for tests or treatment and meanwhile have worsening symptoms or new concerns, get in touch with your healthcare team so that they can reassess your situation.

"Don't delay because you think hospitals are too busy – the NHS still has systems in place to safely treat you."

As the nation went into lockdown in late March there was a significant fall in people seeking help for suspected heart attacks.

The BHF said that in late March the number of people attending A&E with a suspected heart attack dropped by 50%, and although numbers have improved, admission levels remain below previous levels.

It added that thousands have been left waiting for heart investigations such as echocardiograms.

One patient has been waiting since July for a procedure she was told she needed "urgently".

Sarah Fisher, 49, from Bromsgrove, suffered a heart attack in May and has subsequently been diagnosed with heart failure.

In July, she was told she urgently needs an a small device which helps treat people with life-threatening abnormal heart rhythms called an ICD, but this has been delayed due to the pandemic.

"I am so scared about having another heart attack or event while I wait for the ICD," the 49-year-old said.

"I'm now at high risk of a life-threatening cardiac arrest and obviously very anxious.

"I was told I would have had the ICD by now if it wasn't for the delays caused by Covid-19. However, although I'm on the urgent list for one, my cardiologist can't give me any idea of when I will get it.

"Now that cases of Covid-19 are rising again, I'm just so worried how this might delay everything further. I'm still waiting for an appointment with an ICD specialist to discuss it and I feel like I'm in limbo.

"I try not to get angry but it's hard when some people are complaining about not being able to go for a drink and all I want to do is live."

The charity said the pandemic has also had a devastating impact on the BHF's income which could impact future research and care.

Dr Babu-Narayan added: "Covid-19 has put people with heart and circulatory conditions at greater risk than ever.

"The effects of the pandemic have also cut our funding for new life saving research in half. Slowing down now would put even more lives at stake.

"At a time when hearts need help more than ever, we urgently need support."

Professor Nick Linker, national clinical director for heart disease for the NHS in England, said: "The number of people seeking emergency help for heart problems quickly recovered during the first wave, after some people had initial concerns about coming forward for care.

"The NHS has continued to offer treatment for urgent and routine heart problems throughout the pandemic and patients have been able to visit their GP, so nobody should delay coming forward to get the advice and support they need."

The news comes as the UK's leading respiratory charities called on the NHS in England to outline how it plans to address the growing backlog of basic care for people with respiratory problems.

Asthma UK and the British Lung Foundation warned that winter is the deadliest season for people with lung conditions.

The organisations said basic care was the best way to prevent hospital admissions for people with lung problems.

Alison Cook, director of policy and external affairs at Asthma UK and the British Lung Foundation, said: "Failure to prepare for the predictable seasonal spike in respiratory admissions, by ensuring people with lung disease are as well as possible, could threaten to overwhelm the NHS this winter.

"NHS England must urgently outline how it plans to support primary care professionals in restoring basic care, especially for those with respiratory conditions, to prevent an avalanche of unscheduled care and hospital admissions.

"It's critical that people with lung conditions, who are at risk of becoming seriously ill if they get coronavirus, go into winter equipped to deal with their condition, keeping them well and out of hospital."