May 18, 2020
Dr. Jay Jagannathan: Don’t ignore stroke symptoms during COVID-19 pandemic
Kristen Jordan Shamus, Detroit Free Press Published 7:38 a.m. ET May 18, 2020 | Updated 11:19 a.m. ET May 18, 2020
Michael Devine had chest pain.
He thought it was heartburn. He thought it would go away. He tried to will it away.
Because in the middle of a pandemic, Devine, 51, of Redford didn’t want to have to go to the hospital. He wanted to avoid the one place where he knew there would be people with COVID-19.
So Devine chose to wait it out — like nearly one-third of Americans who said they also put off getting medical care to avoid the risk of exposure to novel coronavirus, according to a new poll from the American College of Emergency Physicians and Morning Consult.
As many as 80% of the 2,201 adults polled April 18-20 for the survey said they were concerned about contracting COVID-19 in a hospital emergency room.
“Nobody wants to go to the hospital, especially during this time of COVID-19,” Devine said. “No way you want to go.”
In addition to worries about contracting the virus, Devine said he was also concerned that he would add unnecessary stress to a health system already taxed by the pandemic, taking medical resources from severely ill coronavirus patients who needed critical care.
“I felt like this would just interrupt a doctor that’s working with a patient that’s more important, you know, somebody that probably has COVID-19 on a ventilator.”
The decision to avoid treatment could have killed Devine, who works in distribution for a manufacturing company that has aided in the coronavirus response by producing ventilator parts.
“I had your typical signs of heart attack,” Devine said. “My right jaw hurt. My left arm was killing me and the middle of my chest was hurting. … These are signs of a heart attack, and I was … just in denial.
“I’m like, you know, I think it’s indigestion. I don’t … think it’s that serious.”
After more than a week of off-and-on symptoms, Devine said he woke up in the middle of the night of April 21 into April 22, and “it felt like there was an elephant on my chest.”
Still, he decided to go to work that morning. He’d just been called back after a nearly month-long furlough, and said he was excited to get back on the job.
But as he drove to work the morning of April 22, Devine made a quick decision to instead go to the emergency room at Beaumont Hospital in Farmington Hills.
There, doctors discovered he had, in fact, suffered a heart attack.
“He underwent a cardiac catheterization, and he actually had two critically blocked arteries that we had to open up with stents,” said Dr. Anthony Lutz, a general cardiologist for Beaumont Health, noting that Devine’s right coronary and ramus arteries were blocked.
“Those arteries were supplying the inferior wall of his heart. So it has reduced the squeeze of his heart some. I think he’ll still recover from it, but he did suffer a heart attack because those arteries blocked up, and that had been going on for some time. Those chest pains, you know, if we could have gotten to them earlier, we might have been able to hold off the heart attack.”
Lutz said he and other physicians are very concerned about patients like Devine who aren’t coming to the emergency room when they have serious symptoms that could be signs of heart attack or stroke.
“From our cardiology standpoint, we’ve seen a dramatic decline in people presenting with chest pain and heart attacks and arrhythmia complaints that we’re typically used to seeing,” he said.
“And I think after talking to patients, they’re scared to come to the hospital over fears that they’re going to get sick or be exposed and maybe be worse off had they not come to the hospital.”
Dr. Jay Jagannathan, a neurosurgeon specializing in cranial and spinal surgery in private practice, said even if patients are hesitant to go to an emergency room, they should at the very least call their primary care physician to get advice if they are having any emergency symptoms, whether they are similar to heart attack or stroke.
“The common symptoms of stroke are going to be weakness in one side of the body, particularly weakness that comes and goes and gets better,” Jagannathan said. “That sign is called a transient ischemic attack or TIA. …The other symptoms are going to be … loss of coordination, loss of sensation one side of the body, severe headaches, double vision.”
Increasingly, he said, doctors are seeing blood clots and stroke in COVID-19 patients. Some people, he said, don’t know they have coronavirus at all. Their first symptoms are stroke symptoms.
“It’s found out later on that they actually test positive for COVID as well,” said Jagannathan, who works out of three Michigan hospital systems — Garden City Hospital, which is run by Prime Healthcare, MidMichigan Medical Center, which is run by the University of Michigan Health System, and McLaren Health Care.
Lutz agreed, adding that hospital systems are ready and able to help people who need emergency treatment without exposing them to coronavirus.
“We’re very focused on trying to provide a … safe environment for the patients,” he said. “We have policies and procedures to screen, and make sure everyone’s safe to come to the hospital and that we can treat them … safely.”
But Lutz said he hadn’t realized that some patients, like Devine, were not only concerned about getting coronavirus at the hospital, but they also are worried about being an unnecessary drain on the health care system during the pandemic.
“I wasn’t really thinking that patients were thinking they may be a burden to the health care system,” Lutz said. “I think we need to help them out and say, ‘We do have the capabilities still to handle it. … We’re not overwhelmed.’ I think there was a brief time and there we were. That has passed.
“We want people to come in for the same things they were going to come in with before. If you were concerned enough to think you needed to come to the hospital, we still want you to come to the hospital. We have the capabilities to treat you and you’re not going to be exposed to COVID-19 any more than the general population.”
Devine said he’s grateful he survived his ordeal. At 51, he knows he’s young to have had a heart attack. There’s no family history of heart disease, and he’s otherwise healthy. His biggest risk factor is that he was a smoker.
He’s since given that up.
“I think I’m lucky,” he said. “I think I got very lucky. I really do, I. … God must have a certain reason.”
Devine has recovered enough to return to work, and also has started to make other lifestyle changes, too.
“If I follow these steps, I can have many years left. … If I keep doing the right things, I’ll have longevity,” he said.
Contact Kristen Shamus: 313-222-5997 or kshamus@freepress.com. Follow her on Twitter @kristenshamus.
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