Having symptoms of a heart attack or stroke? Go to the emergency department, COVID-19 concerns or not


Since mid-March, when the novel coronavirus became a concern in the U.S., people have opted to stay home — sometimes even when they need emergency medical attention.

According to recent data, “one out of every five people having either a heart attack or a stroke have not come to the emergency department for care,” says Ravi Dave, MD, the director of interventional cardiology at UCLA Health and a professor of medicine at the David Geffen School of Medicine at UCLA. “Considering that someone in the U.S. has a heart attack every 40 seconds, this is a huge number.”

The obvious problem with waiting, Dr. Dave says, is that the clock starts as soon as the first symptoms appear. The faster a person gets treatment, the greater the chance of not dying or experiencing permanent heart muscle damage that could lead to congestive heart failure or sudden cardiac death, or in the case of stroke, lifelong paralysis.

Doctors across the U.S. are reporting that patients are now showing up sometimes as late as a week after their heart attack or stroke, Dr. Dave says, at which point, there is little physicians can do to reduce damage.

“Any treatment in the first 90 minutes can be potentially life-saving,” Dr. Dave says, adding that if a patient opts to stay home and monitor the symptoms, “they risk a poor outcome.”

As concerns about COVID-19 continue, physicians and leaders from the American Heart Association and other national organizations want everyone to know they should call 911 or go to the emergency department if they suspect a heart attack or stroke, or have any other medical emergency.

Here’s what else to keep in mind:

Know the symptoms of heart attack and stroke

The symptoms of a stroke include face drooping, arm weakness, slurred speech and sudden numbness, confusion or trouble walking or seeing, according to The American Stroke Association.

The most common heart attack symptom is chest pain or discomfort. Other symptoms include jaw pain, arm numbness, nausea and shortness of breath, although women’s symptoms can be a bit less clear.

When in doubt, patients should come in and be checked out rather than try to manage symptoms at home or wait for an appointment with their doctor. “There’s no time to waste when dealing with a heart attack or stroke,” Dr. Dave says.

For people who worry that they’re over-inflating concerns, and would rather take a wait-and-see approach, Dr. Dave notes that 80% of people who come into the emergency department with symptoms of a stroke are actually having a stroke.

While that percentage is much lower for heart attacks, it cannot be ruled out without a physical exam and evaluation. “There’s no way to know what’s going on unless you come in,” he says.

Emergency departments have upped their infection prevention protocols

If you go to a UCLA Health emergency department today, you’ll see enhanced infection prevention protocols in place even before entering the building.

Currently, every patient, visitor and staff member is pre-screened before they enter the hospital, which includes a temperature check and symptom monitoring. Patients who present with heart attack or stroke symptoms are brought into a separate area to receive treatment.

Inside the hospital, everyone must wear a mask or other face covering and follow physical-distancing guidelines. There are also enhanced disinfection and sterilization processes in place throughout the buildings in exam areas and on high-touch surfaces such as elevator buttons and digital screens.

“The risks of ignoring a heart attack or stroke are much worse than any risk of being exposed to the coronavirus disease when seeking care,” Dr. Dave says.

Don’t skip your routine appointments either

In addition to avoiding emergency department visits, concerns about coronavirus have kept people from seeking more routine or follow-up care, Dr. Dave says.

The same infection prevention policies are in place in all of UCLA Health’s primary and specialty care medical clinics, and in some cases, video visits are also an option.

“We want patients to stay engaged and keep their health care on track,” Dr. Dave says.

If you would like more information about the UCLA Health response to COVID-19, visit our dedicated website at uclahealth.org/coronavirus.