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Coronavirus and inherited cardiac conditions: frequently asked questions

Information for patients

We know that this is a concerning 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 or circulatory condition it may mean that you could get more ill if you get coronavirus (COVID-19), which is why it's really important to protect yourself.

  • As always, we remain completely committed to caring for you and your family. If you are worried about your health or feel that your symptoms are getting worse, please let us know so that we can give you the help and treatment you need.
  • If you have been called about, or have an upcoming appointment, we may ask you to see a different doctor or nurse as members of our team are being deployed to help other departments in the hospital.
  • Where appropriate, we may hold appointments over the phone or via a video service.

Frequently asked questions

  • I am worried I might have coronavirus (COVID-19)

    Please also bear in mind that the majority of patients, including the majority of cardiac patients, will make a full recovery from coronavirus (COVID-19).

    Do not leave your home if you have coronavirus symptoms:

    • a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
    • a new, continuous cough – this means coughing a lot for more than an hour, or three or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual).

    To protect others, do not go to places like a GP surgery, pharmacy or hospital. Stay at home.

    Use the NHS 111 online coronavirus service to find out what to do. Only call 111 if you cannot get help online.

  • I have been referred to the service but have not heard anything

    We know that this is a concerning time, especially if you have an existing health problem or have been referred to see a cardiologist.

    We have received your referral and if your appointment is urgent, you will be scheduled for a face-to-face appointment or a clinician may contact you by phone.

    We are currently not scheduling any new patients unless they are clinically urgent. All other patients will remain on our waiting list and we will be in touch with you as soon as we can.

  • I am on medication prescribed by your team and am not sure if I should stop them

    Do not stop any medication unless specifically told to do so by your clinical team. 

    Based on the current evidence, the team strongly recommends that all patient using ACE-i/ARB for hypertension, post MI LV dysfunction, hypertension, ischaemic heart disease, and heart failure with reduced ejection fraction should continue treatment with their usual therapy during the coronavirus (COVID-19) outbreak.

  • I have an appointment soon and have not heard from you

    We know that this is a concerning time, especially if you have an existing health problem or have an upcoming appointment with a specialist. We are attempting to contact all patients in advance of your appointment. If you haven’t heard from us and your appointment is less than three days away please contact us on gst-tr.iccnurses@nhs.net.

  • I am unable to get in touch with my usual doctor or nurse and am worried

    We are really sorry as we know it is a very stressful time, especially if you can’t speak to the people who know you best.

    Our inherited cardiac conditions team is a large team, and lots of us have (and will be) deployed to help other teams during this unprecedented challenge of the coronavirus situation.

    Another doctor or nurse may be handling your care and will contact you in the meantime.

  • I have symptoms that are worrying me

    If you have symptoms that could be a medical emergency (such as a heart attack or stroke), dial 999.

    If you are concerned that your symptoms relate to coronavirus (COVID-19), you should use the NHS 111 online coronavirus service to find out what to do. To protect yourself from exposure to coronavirus (COVID-19), you should remain at home and follow government advice on social distancing and self-isolation.

    Whether or not you have coronavirus symptoms, it is essential to come to hospital if you have a medical emergency, or if your heart symptoms get much worse.

    Despite the pressure that the NHS is under, you should always dial 999 immediately if you:

    • have sudden chest pain which spreads to your arms, back, neck or jaw
    • have sudden chest pain which feels heavy or tight
    • show signs of a stroke, such as your face drooping on one side, are unable to hold both arms up, or have difficulty speaking.
    • have severe difficulty breathing such as gasping for breath, choking, lips turning blue, or not being able to get words out.

    If the symptoms are related to the condition that are long standing and you need specific clinical advice from our team please contact us on gst-tr.iccnurses@nhs.net.

  • My medication is running out and I need a prescription

    If your medication is usually prescribed by your GP contact the surgery. If we usually prescribe your medication, please contact us on gst-tr.iccnurses@nhs.net.

  • I have heart failure and am worried about getting coronavirus (COVID-19). Should I shield myself/self-isolate?

    Coronavirus can make anyone seriously ill. But some people are at a higher risk and need to take extra steps to avoid becoming unwell. 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 or circulatory condition it may mean that you could get more ill if you get coronavirus, which is why it’s really important to protect yourself.

    Some heart patients are considered at extremely high risk of severe illness from coronavirus. You are classed as extremely vulnerable if you have had an organ transplant at any time, or are pregnant with significant heart disease. If you are in one of these groups, you should protect yourself by staying at home and minimising contact with people you live with, for the next 12 weeks. This is called shielding.

    If this applies to you, you will be contacted directly by the NHS with further advice. If you think you fall into one of these categories but have not received a letter, email or text by Thursday April 2, you should discuss your concerns with your GP or specialist doctor or nurse.

    Coronavirus (COVID-19) 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. This list is based on the best information available from relevant experts. It is 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.

    Even if you are not at extremely high risk, you should be staying at home apart from essential needs as per current advice, as you may still be at particularly high risk because of your heart condition. You may be at particularly high risk if you have:

    • heart disease and are over 70
    • heart disease and lung disease/chronic kidney disease
    • 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). A heart murmur that does not cause you symptoms doesn't put you at high risk.
    • you're recovering from recent open-heart surgery in the last three months (including heart bypass surgery)
    • cardiomyopathy (any type) if you have symptoms such as breathlessness, or it limits your daily life, or you’ve been told you have problems with your heart function
    • 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 (such as Fontan, single ventricle or cyanosis).

    To learn more about people in the higher risk and extremely vulnerable groups and what they should do, please visit the Gov.uk website and the British Heart Foundation’s page, Coronavirus: what it means for you if you have heart or circulatory disease.

  • Under what circumstances should I come to hospital?

    In most cases we should be able to answer questions about your health without you having to come to hospital. But there may be occasions where you should dial 999. NHS 111 online is another resource, particularly if you are self-isolating for possible coronavirus infection and feel your illness is worsening.

    The most important is probably a sudden unexplained blackout or fall. It is common to feel dizzy on sudden standing up after a long period of sitting (or after lying down at night), and simple faints are usually preceded by warning symptoms. These may be a feeling of warmth, sweating, dizziness, or tunnel vision. However, you should go to hospital if you suddenly find yourself on the floor for no apparent reason when sitting or walking around, as this could be due to a disturbance of heart rhythm.

    Although most patients with inherited heart disease do not have coronary artery disease and are not at risk of heart attack, in the event of severe chest pains lasting over 20 minutes continuously you should also ring 999.

  • I have Brugada syndrome and am worried about getting a fever with coronavirus (COVID-19). What should I do?

    Detecting and treating fever is important in this condition. We would recommend the following for patients with Brugada syndrome.

    • Follow the government's advice regarding social distancing and, where appropriate, self-isolation. This advice may well change and it is important to check the government coronavirus website frequently for updates.
    • Ideally you should have a thermometer at home. It may be difficult to obtain one in the current situation. If you feel unwell and you are able, please take your temperature. A temperature higher than 38°C is considered a fever and should be treated. We recommend:
      • ensure that you are well hydrated
      • take paracetamol, following instructions on the packet (no more than the recommended dose)
      • if this does not bring your fever down consider taking ibuprofen, though do not take it on an empty stomach or if you have a history of gastric (stomach) problems, such as an ulcer of inflammation
      • additional measures that may help include lowering the room temperature (if appropriate), taking a tepid (not cold) bath, or a sponge down, and eating cold foods
      • get lots of rest.

    Fever is one of the warning signs for possible coronavirus and the development of a fever is a reason to self-isolate. We recommend that in the event of a fever you self-isolate for seven days, as per current government advice (or longer if your symptoms persist). If a member of your family develops any of the warning symptoms (new continuous cough or high fever), you should self-isolate for 14 days.

    If you develop a high fever (40°C or higher) which persists, despite taking the measures above and if you do not have an implantable cardioverter-defibrillator (ICD), you should attend your local A&E department for an ECG and possible admission for cardiac monitoring.

    Continue to follow the usual advice we give to all patients with Brugada syndrome, including the prompt treatment of any diarrhoea and vomiting, avoiding very heavy meals or alcohol intake just before bedtime, and avoiding medications that may increase the risk of heart rhythm disturbances.

  • Is there any specific advice for patients with Long QT syndrome?

    There is little specific advice beyond the usual advice we give to patients with Long QT syndrome (or patients with a prolonged QT on their ECG where a definite diagnosis of an inherited condition has not been made).

    It is thus important to avoid potential QT prolonging drugs, and not to stop taking beta-blocking drugs if already prescribed. Fever as seen with coronavirus does not generally seem to cause a problem in Long QT patients. A possible exception is patients with Long QT syndrome type 2. These patients should probably take paracetamol to reduce a fever (or antibiotics if appropriate for a bacterial infection). Diarrhoea and vomiting should be treated promptly (eg. Dioralyte) to prevent low potassium levels.

  • As a patient with cardiomyopathy, how do I know if I am high risk and need strict self-isolation?

    Patients with cardiomyopathy at increased risk of complications from coronavirus include:

    • patients with dilated cardiomyopathy (DCM), arrhythmogenic cardiomyopathy (ARVC or AC) and hypertrophic cardiomyopathy with left ventricular impairment (left heart failure) or symptoms of left heart failure (eg breathlessness, needing to sleep with more pillows at night)
    • patients with arrhythmogenic cardiomyopathy (ARVC or AC) with right ventricular impairment (right heart failure) or symptoms of right heart failure (eg ankle/leg swelling)
    • patients with hypertrophic cardiomyopathy (HCM) and symptoms

    If any of the above statements apply to you, we recommend strict self-isolation.

    Cardiomyopathy - the heart muscle charity website includes helpful information regarding coronavirus (COVID-19) and self-isolation for patients with cardiomyopathy as well as your benefits, rights, and common myths.

  • Should I stop smoking because of coronavirus (COVID-19)?

    All the evidence suggests smokers are at higher risk of complications from coronavirus.

    Smoking increases your risk of catching it (because you touch your mouth more frequently when smoking) and because it damages your lungs and general health.

    If you smoke, please try to stop smoking today.