Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, 247000 Karachi, Pakistan.
Department of Internal Medicine, Ziauddin Medical University, 247000 Karachi, Pakistan.
Rev Cardiovasc Med. 2021 Mar 30;22(1):83-95. doi: 10.31083/j.rcm.2021.01.241.
The coronavirus disease-19 (COVID-19) pandemic has forced hospitals to prioritize COVID-19 patients, restrict resources, and cancel all non-urgent elective cardiac procedures. Clinical visits have only been facilitated for emergency purposes. Fewer patients have been admitted to the hospital for both ST-segment elevation myocardial infarctions (STEMI) and non-ST segment elevation myocardial infarctions (NSTEMI) and a profound decrease in heart failure services has been reported. A similar reduction in the patient presentation is seen for ischemic heart disease, decompensated heart failure, and endocarditis. Cardiovascular services, including catheterization, primary percutaneous coronary intervention (PPCI), cardiac investigations such as electrocardiograms (ECGs), exercise tolerance test (ETT), dobutamine stress test, computed tomography (CT) angiography, transesophageal echocardiography (TOE) have been reported to have declined and performed on a priority basis. The long-term implications of this decline have been discussed with major concerns of severe cardiac complications and vulnerabilities in cardiac patients. The pandemic has also had psychological impacts on patients causing them to avoid seeking medical help. This review discusses the effects of the COVID-19 pandemic on the provision of various cardiology services and aims to provide strategies to restore cardiovascular services including structural changes in the hospital to make up for the reduced staff personnel, the use of personal protective equipment in healthcare workers, and provides alternatives for high-risk cardiac imaging, cardiac interventions, and procedures. Implementation of the triage system, risk assessment scores, and telemedicine services in patients and their adaptation to the cardiovascular department have been discussed.
新型冠状病毒病-19（COVID-19）大流行迫使医院优先考虑 COVID-19 患者，限制资源，并取消所有非紧急的选择性心脏手术。仅为紧急目的而方便进行临床访问。因 ST 段抬高型心肌梗死（STEMI）和非 ST 段抬高型心肌梗死（NSTEMI）而入院的患者较少，心力衰竭服务也大幅减少。缺血性心脏病、失代偿性心力衰竭和心内膜炎的患者就诊情况也类似减少。心血管服务，包括导管插入术、经皮冠状动脉介入治疗（PPCI）、心电图（ECG）等心脏检查、运动耐量试验（ETT）、多巴酚丁胺负荷试验、计算机断层扫描（CT）血管造影、经食管超声心动图（TOE）已报告有所减少，并按优先顺序进行。已经讨论了这种减少的长期影响，主要关注严重的心脏并发症和心脏患者的脆弱性。大流行也对患者造成了心理影响，导致他们避免寻求医疗帮助。本综述讨论了 COVID-19 大流行对各种心脏病学服务提供的影响，并旨在提供恢复心血管服务的策略，包括对医院进行结构性调整以弥补减少的工作人员、在医护人员中使用个人防护设备，以及为高风险心脏成像、心脏介入和程序提供替代方案。还讨论了分诊系统、风险评估评分和远程医疗服务在患者中的实施及其对心血管科的适应。
