Our charity partner, the British Heart Foundation, have medical experts who explain what we know so far about the Covid-19 coronavirus and how it can affect people with heart disease.
Further information can be viewed on the BHF website https://www.bhf.org.uk/informationsupport/heart-matters-magazine/news/coronavirus-and-your-health
Updated Monday 23 March 2020
I have a heart or circulatory condition – am I at increased risk of coronavirus?
We know that this is a frightening time for lots of people, especially if you have an existing health problem. Most people with coronavirus (Covid-19) have mild symptoms and make a full recovery. Having a heart and circulatory condition probably doesn’t make you any more likely to catch coronavirus than anyone else. But if you have a heart condition it may mean that you could get more ill if you catch it, which is why it’s really important to protect yourself.
Anyone with a heart condition is considered high risk of more severe complications of Covid 19 coronavirus.
Some groups may have a higher risk than others so it’s important you keep up to date with the government’s advice, available on their website.
The government has recently updated their advice for people at extremely high risk of severe illness from Covid-19 because of an underlying health condition, and for their family, friends and carers. It involves more strict protective measures, called shielding.
Some heart patients are considered at extremely high risk. This applies to you if:
- you are pregnant and have significant heart disease (congenital or acquired)
- you have had a transplant at any time, including a heart transplant.
Shielding is a measure to protect extremely vulnerable people by minimising interaction between those who are extremely vulnerable and other people. The government has advised that if you are considered extremely vulnerable, you should not leave your home, and within your home, minimise all non-essential contact with the people you live with.
If you are in one of these groups, you will be contacted directly by the NHS in England with further advice. The government is advising that you stay at home at all times and avoid any face-to-face contact for a period of at least 12 weeks from the day you receive your letter from the NHS. Please note that this period of time could change. If you think you fall into one of these categories but have not received a letter by Sunday 29 March 2020 or been contacted by your GP, you should discuss your concerns with your GP or hospital clinician.
The government’s website provides detailed information on how to practice shielding in your home and how to stay safe if you live with others. It’s really important that you read the government’s advice in full.
Covid-19 coronavirus is a new disease and we don’t know everything about who is most at risk of complications. Other heart patients may still be at particularly high risk or high risk. If you are in either of these groups, you should be particularly stringent in following social distancing measures. This list is based on the best information available from relevant experts. It’s possible that other conditions could put you at risk that we don’t know about yet, so it’s important that everyone works hard not to catch or spread coronavirus.
Some heart patients are considered particularly high risk. This applies to you if:
- You have heart disease and you’re over 70
- You have heart disease and lung disease or chronic kidney disease
- You have angina that restricts your daily life or means you have to use your GTN frequently
- Heart failure, especially if it restricts your daily life or you’ve been admitted to hospital to treat your heart failure in the past year
- Heart valve disease that is severe and associated with symptoms (such as if you regularly feel breathless, or you have symptoms from your heart valve problem despite medication, or if you are waiting for valve surgery)
- You’re recovering from recent open-heart surgery in the last three months (including heart bypass surgery)
- Congenital heart disease (any type) if you also have any of the following: lung disease, pulmonary hypertension, heart failure, you’re over 70, you are pregnant, or if you have complex congenital heart disease.
If any of these apply to you, this means you are at high risk:
- Coronary heart disease, such as a past heart attack, stent, or bypass surgery (at any time)
- Over 70 years old
- High blood pressure (hypertension)
- Lung disease, including asthma
- Chronic kidney disease
- Vascular dementia or small vessel disease in the brain
- Any long-term condition that means you get the flu jab every year.
If you have atrial fibrillation, there isn’t enough information at the moment to tell whether it or other abnormal heart rhythm problems put you at higher risk from coronavirus. It seems likely if you have well controlled atrial fibrillation, that your risk is lower than for the groups mentioned above.
You can see the full list of affected conditions on the government website.
What should I do if I get chest pain?
Whether or not you have coronavirus symptoms, it’s essential to dial 999 if you have symptoms that could be a heart attack. Some recent information from Italy suggests that people are not seeking help for possible heart attack symptoms, or waiting longer to seek help, which means more of them needing intensive care or suffering long-term heart damage.
Despite the pressure that the NHS is under, you should always dial 999 immediately if your chest pain is sudden, spreads to your arms, back, neck or jaw, and feels heavy or tight, or if you become short of breath or start to feel sick.
What should I do to avoid coronavirus?
Everyone needs to work hard not to catch or spread Covid-19 coronavirus. This applies whoever you are, so that you stay healthy and don’t pass it on to vulnerable people. And it applies especially if you’re in a high or very high risk group, such as the conditions listed above.
The government has issued advice on social distancing for everyone and for protecting older and vulnerable adults. Social distancing is a really important way to slow transmission of Covid-19 and to help to protect yourself from catching it. Everyone should be trying to follow these measures. For those who are over 70, have a serious underlying health condition or are pregnant, it is strongly advised that you follow social distancing as much as you can, and try to significantly limit your face-to-face interaction with friends and family. If you are considered extremely high risk, you need to practice stricter measures called shielding.
- Read about the difference between social distancing and self-isolation
You may receive a message not to attend your routine hospital appointments in person and information about alternative arrangements.
The government say this advice is likely to be in place for some weeks and may change frequently so be sure to check their website.
What else can I do to reduce my risk of Covid-19 coronavirus?
While it is normal to feel anxious about how this condition might affect you, the good news is we know that people with heart and circulatory diseases are at no greater risk of getting it than anyone else. You may be able to protect yourself further if you follow the advice provided by the NHS and the UK government:
- wash your hands with soap and water often – do this for at least 20 seconds
- cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- put used tissues in the bin immediately and wash your hands afterwards
- avoid people who cough and sneeze or who you know are currently unwell with the symptoms, as well as social distancing in general
- it’s still really important to carry on taking any medication you’ve been prescribed, even if you feel unwell. Ask someone to collect your prescriptions from the pharmacy if necessary.
Is it true that my blood pressure medications could cause more severe coronavirus (Covid-19) infection?
We’d strongly advise people to continue taking all their medications unless advised differently by their doctor.
The medical profession has a number of expert groups who have reviewed the scientific information and they are agreed that there is a lack of evidence to support speculation that ACE inhibitors and angiotensin receptor blockers (ARBs) increase the chances of severe Covid-19 infections.
What is clear is that stopping your medication could be dangerous and could make your condition worse. These drugs are very effective for heart failure, and to control high blood pressure to help prevent a heart attack or stroke. It’s really important that you continue to take them as prescribed, unless advised differently by your doctor.
What should I do if I have congenital heart disease?
It’s important for everyone to follow the most up to date government and NHS advice on avoiding infection, when to self-isolate and for how long, including children and adults with congenital heart disease.
Congenital heart disease comes in many different forms and many patients may have mild Covid-19 symptoms, just like everyone else.
According to specialists, congenital heart disease patients that are at particular risk of more severe Covid-19 illness include those that are over-70, have lung disease, complex congenital heart disease, pulmonary hypertension or heart failure. The risk to children from coronavirus is lower, and the main concern is that children may spread the virus to more vulnerable groups. For more guidance on specific congenital heart conditions, please visit The British Congenital Cardiac Association’s website, here.
Contact your specialist nurse or specialist centre for specific advice on your child if you have additional concerns, and continue to check the UK Government’s website for new information.
At this stage all congenital heart disease patients, including children, should follow the same advice as other high-risk groups and be extra vigilant with social distancing measures. If you experience Covid-19 symptoms and they get worse, you should contact 111 in line with the government’s advice.
Where can I get more information?
The information provided by the government is updated daily. However, if you live with a heart or circulatory condition and would like to speak with a cardiac nurse, you can call 0300 330 3300, Monday to Friday 9am-5pm.
The World Health Organization (WHO) regularly updates its website on the global picture as well as providing myth-busters to the unreliable information that is circulating about this condition.
animals to human, as is the case in several instances. The current outbreak is called a novel coronavirus as it has not been identified previously in humans.
The BHF recommends that everybody closely follows the advice provided on the NHS and Government webpages, as they are updating their information daily. If those living with heart and circulatory diseases, or its risk factors, would like to speak with a cardiac nurse, they can contact our Heart Helpline.