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Review
. 2020 Aug 25;13(8):e237817.
doi: 10.1136/bcr-2020-237817.

Community and healthcare system-related factors feeding the phenomenon of evading medical attention for time-dependent emergencies during COVID-19 crisis

Taha Ahmed  1 , Samra Haroon Lodhi  2 , Samir Kapadia  3 , Gautam V Shah  3
Affiliations
Review

Community and healthcare system-related factors feeding the phenomenon of evading medical attention for time-dependent emergencies during COVID-19 crisis

Taha Ahmed et al. BMJ Case Rep. .

Abstract

The current COVID-19 crisis has significantly impacted healthcare systems worldwide. There has been a palpable increase in public avoidance of hospitals, which has interfered in timely care of critical cardiovascular conditions. Complications from late presentation of myocardial infarction, which had become a rarity, resurfaced during the pandemic. We present two such encounters that occurred due to delay in seeking medical care following myocardial infarction due to the fear of contracting COVID-19 in the hospital. Moreover, a comprehensive review of literature is performed to illustrate the potential factors delaying and decreasing timely presentations and interventions for time-dependent medical emergencies like ST-segment elevation myocardial infarction (STEMI). We emphasise that clinicians should remain vigilant of encountering rare and catastrophic complications of STEMI during this current era of COVID-19 pandemic.

Keywords: cardiovascular medicine; global health; healthcare improvement and patient safety; interventional cardiology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Twelve-lead ECG shows wide complex tachycardia at a ventricular rate of approximately 200 beats/minute. (B) Twelve-lead ECG shows repolarisation abnormalities in leads II, III and aVF (blue arrows).
Figure 2
Figure 2
Coronary angiogram in left anterior oblique cranial view shows (A) complete occlusion of mid-distal right coronary artery (yellow arrow) and (B) stenosis of the left anterior descending artery (yellow arrow).
Figure 3
Figure 3
Twelve-lead ECG shows ST-segment elevations in leads V2–V6 (blue arrows) with Q waves in leads I, aVL and V5–V6 (red arrows).
Figure 4
Figure 4
Transthoracic echocardiogram still image of parasternal long axis view with colour flow shows ventricular septal rupture with left to right shunt (yellow arrow).
Figure 5
Figure 5
(A) Coronary angiogram (CA) in left anterior oblique (LAO) cranial view shows total occlusion of proximal left anterior descending artery (LAD) (blue arrow). (B) CA in right anterior oblique (RAO) caudal view shows occlusion of proximal LAD (orange arrow). (C) CA in LAO cranial view shows 40% stenosis of right coronary artery (green arrow). (D) Left ventriculogram in LAO cranial view shows left to right shunt with dye in right ventricle (yellow arrows).
Figure 6
Figure 6
Cardiac MRI in short axis view shows small ventricular septal defect (yellow arrow).
See this image and copyright information in PMC

References

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