Guidance on care and treatment of patients with cardiovascular disease in the context of the COVID-19 pandemic

World Heart Federation tiedottaa:

We at the World Heart Federation are concerned that the COVID-19 pandemic is leading to overwhelmed health systems in many countries in the world. We are in the midst of a crisis, and it is our role to advocate for maintaining essential health services and continuing to provide life-saving and life-sustaining treatment to patients with cardiovascular disease.

WHF supports the emergency care concepts currently being planned or put in place in many hospitals around the world for the care of seriously ill COVID-19 patients. Competent cardiovascular care for these individuals is essential and guideline-compliant care, even under the most difficult circumstances, especially for critically ill patients, needs to be ensured.

We know from our experience with previous influenza epidemics that respiratory infections are accompanied by a sudden increase in life-threatening heart diseases, and not just acute coronary syndromes. With all the necessary shifting of capacities, especially in the intensive care units to care for critically ill COVID-19 patients, we must not lose sight of the fact that a guideline-compliant treatment of cardiovascular emergency patients remains guaranteed. 

This includes not only patients with acute coronary syndrome, but also patients with high-grade mitral valve insufficiency, symptomatic high-grade aortic valve stenosis, acute decompensated heart failure due to underlying cardiomyopathy of other structural heart disease, acute pulmonary embolism and life-threatening cardiac arrhythmias, which very often become clinically noticeable with the classic symptom of dyspnea.

Clinically active colleagues need to take special care of this critical patient population and ensure that resources are allocated appropriately in their hospitals.

In times of such an unprecedented pandemic, physicians and patients rush into the use of medications, such as chloroquine or antiretroviral drugs, for the prevention of COVID-19. There is currently no evidence to do so. Those medications can cause serious health consequences, including death, and they should not be used without any evidence of benefit.
We hope that this guidance on care and treatment of patients with cardiovascular disease in the context of the COVID-19 pandemic is useful and we remain determined to serve our community throughout the crisis.

Karen Sliwa, President, World Heart Federation
Jean-Luc Eiselé, CEO, World Heart Federation
Fausto Pinto, President-Elect, World Heart Federation