Coronavirus, heart disease and stroke

Updates and precautions for people living with heart disease or stroke

If you or someone you love has had a stroke or is living with a heart condition, the spread of coronavirus disease (COVID-19) may be especially worrying.

Dr. Cindy Yip, director of Data, Knowledge Management and Heart Program for Heart & Stroke, summarized the available information to answer these questions.

What do we know about the virus?

This virus is still very new. There are a lot of things we don’t know — such as how it might impact our heart and brain health.

The data suggest that people who have a heart condition or vascular disease, or who have had a stroke, may be at higher risk of complications if they are infected with COVID-19. 

So it’s important to do everything you can to avoid infection.

How can I protect myself from exposure to the virus?

Most important is frequent and thorough handwashing, following guidelines from the Public Health Agency of Canada (PHAC) plus your provincial and local public health authorities. Avoid touching your face as much as possible, and clean high-touch surfaces frequently with regular household cleaners or diluted bleach (one part bleach to nine parts water).

By now you will be familiar with the recommendations to reduce contacts with other people through social distancing. If you have heart or vascular disease or have had a stroke, these are factors to consider:

  • Make sure you have a list of contacts – caregivers, healthcare providers, home care staff, as well as family members and friends who could help you.
  • Ensure you have a supply of current prescriptions and check if your pharmacy provides home delivery. It’s a good idea to ensure someone in your family is familiar with your prescriptions and can refill them.
  • In stocking up on non-perishable foods, give priority to heart-healthy choices. For example, if you have heart failure, it’s important to control the amount of salt you consume. Check labels to choose lower salt and no-salt-added options.

Meanwhile ensuring that you’re eating a healthy diet and getting regular physical activity will help maintain your heart and brain health. And of course it's a good idea to avoid tobacco smoking.

Should I keep taking all my medications?

Yes. You should continue to take all your medications as prescribed.

There are reports circulating that some heart medications may increase your risk of COVID-19. There is no scientific evidence to suggest this is true.

In fact, if you stop some of your medications you may feel worse from your health condition and require medical attention.

This advice applies to medications including ACE inhibitors (angiotensin converting enzyme) and ARBs (angiotensin receptor blockers), commonly used drugs to treat both heart failure and high blood pressure.

Talk to your healthcare provider if you have concerns, or see the recommendations from these organizations:

Should I avoid going to medical appointments?

During this outbreak it’s wise to stay home as much as possible to minimize your risk of being exposed to the virus.

However, it’s important to seek medical care when you need it. And it’s not always easy to know.

The Canadian Cardiovascular Society is advising healthcare providers to suspend non-essential appointments and consult with their patients by phone or online conferencing where possible. 

Contact your clinic or doctor’s office and ask if these services are available or advisable for you.

If an in-person appointment is necessary, follow the PHAC guidelines to minimize the risk of exposure to the coronavirus.

Public health authorities are vigilantly monitoring the situation and providing advice to doctors and other healthcare providers. So there should be measures in place at your doctor’s office to protect both patients and medical team members.

Should I attend my regular INR checks at the clinic?

That depends. If you are taking warfarin, a blood thinner, regular monitoring of your INR level is important. At the same time, your healthcare team wants to minimize your risk of exposure to the coronavirus.

Before making any changes you need to discuss this with the physician or nurse who monitors your levels.

If your INR level has been relatively stable, they may advise that you can reduce the frequency of testing. In that case you should continue to carefully monitor your food intake and be extra aware of foods that impact INR levels.

If your INR is fairly unstable and requires frequent dosing adjustments, there may be home-care testing services in your area. Or you may need to keep to your regular schedule of clinic visits. Again, your healthcare provider is in the best position to advise you.

Home monitoring devices are available but not covered by most drug plans and can be quite costly.

What if I experience the signs of a stroke or heart attack or cardiac arrest?

Call 9-1-1 immediately. Don’t be afraid to seek medical help.

What should I do if I think I have COVID-19?

Isolate yourself as quickly as possible and contact your healthcare provider or local public health authority or the COVID hotline in your province to find out where and how you can get assessed.

This information will help you assess your symptoms and connect to testing in your province.

Call ahead before going to any medical office or clinic.

The sooner you can get recommendations on how to alleviate your symptoms, the higher your chance of recovery.

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