Heart attacks – don’t delay treatment, the NHS is ready for you

In this blog, Professor Simon Ray, President of the British Cardiovascular Society reiterates the importance of seeking immediate treatment for heart attacks and heart failure during the coronavirus pandemic.

In the UK we can be justifiably proud of our service for the emergency treatment of heart attack. Patients with suspected heart attack are transferred as emergencies to one of a network of heart attack centres for immediate assessment. Treatment to open up blocked arteries supplying the heart muscle runs 24/7 throughout the year. Thanks to collaboration between hospitals and the efforts of managers and staff within heart units this service has been kept going even at the height of the COVID pandemic. That this has happened is a great tribute to the teams involved who have sometimes worked under very difficult circumstances.

We know this type of treatment saves lives. It works best when started as early as possible after the start of symptoms. The more rapidly a blood vessel can be reopened the better the chance of the patient getting home quickly and back to a normal life. Like a lot of my colleagues around the country, I am worried by evidence that fewer people than usual are coming to hospital with heart attacks. This might sound a strange thing to say, no cardiologist wants anyone to have a heart attack, but it suggests that people are not calling for help with when they develop chest pain or other symptoms. I understand that people will be reluctant to come in to hospital at the moment either because they are worried about getting infected with COVID or that they don’t want to burden a busy NHS. These are understandable concerns, but it is very important that the public at large get the message that heart units across the country are still open and treating emergencies and the risk of ignoring symptoms of a heart attack is very real. Many of my colleagues around the UK have seen people who have arrived in hospital too late for effective treatment, sometimes with life threatening problems. The problem is not just a UK one. Experience from our colleagues in Italy suggests that more people than usual have died at home of heart attacks without reaching hospital and this is not something that we can risk happening here.

Another issue that has been causing a lot of concern nationally is that some sections of the population are at greater risk than others of developing serious problems from COVID infection. Older people, especially men over the age of 70, people living with diabetes and those with underlying heart conditions are all at greater risk. The same is true for people from some Black and Asian backgrounds. It is entirely understandable that people from these groups are reluctant to risk any possibility of being exposed to the virus, but they are also some of those most at risk of suffering a heart attack or other serious heart problem. So, the message is the same, the NHS is there to help you when you need it, irrespective of who you are, so please help us to help you, and come forward for care when you need it.

Most of the recent focus has been around heart attacks but it is important to remember that there is more to heart disease than heart attacks. Heart failure, where the heart muscle does not pump normally, and disease of the valves of the heart can cause breathlessness which can get worse rapidly. Some abnormalities of the heartbeat can cause severe palpitations or unexplained fainting or collapse. All of these are problems that may require urgent treatment, which can be dangerous if left alone.

Some of my colleagues at Manchester University Hospitals have made a short video which I think summarises the situation very well.

Professor Simon Ray

Professor Simon Ray is the National Clinical Director for Heart Disease.

Simon graduated from Bristol University in Pharmacology in 1980 and in Medicine in 1983. After house officer jobs in Bristol and medical senior house office and registrar jobs in Glasgow and Edinburgh he completed his Doctor of Medicine degree as a British Heart Foundation funded research fellow with Professor Henry Dargie in Glasgow.

He continued cardiology training at the Freeman Hospital in Newcastle before moving to Liverpool Heart and Chest Hospital as a senior registrar in 1992. From 1994-1995 Simon was an interventional cardiology fellow in Vancouver, British Columbia, with Ian Penn, Chris Buller and Donald Ricci before appointment as consultant cardiologist at Wythenshawe Hospital in 1995.

His clinical and research interests have focussed around valve disease, patent foramen ovale, cardiac involvement in neuromuscular disease and more recently cardio-oncology. Simon was Clinical Director of Cardiology at Manchester University NHS Foundation Trust from 2006-2009, President of the British Society of Echocardiography 2007-2009, Vice President of the British Cardiovascular Society for clinical standards from 2010-2013 and President of the British Heart Valve Society from 2013-2016.

Simon was appointed Honorary Professor of Cardiology in 2011 and was President of the British Cardiovascular Society, 2018-2021.