What are we doing at CSC to continue care of acute, chronic and complex cardiovascular disease during the Corona Virus Pandemic?
Central Sydney Cardiology is the largest Cardiology Practice in the Sydney Local Health District and has substantial capacity to adapt and adjust to the change in circumstances we are in.
We work closely with the Sydney Local Health District (Sydney LHD), our colleagues in General and Specialist Practice in Sydney, and Country New South Wales. We have been using remote monitoring, remote care and remote working technology for many years and are making the rapid adjustments needed to allow us to maintain continuity of care for our patients.
Our Cardiologists are monitoring the scientific data on the impact of Corona virus infection and what it means for our patients. We will update our general advice as more information emerges. Specific advice will be given by the treating Cardiologist via the appropriate channel (phone advice/letter/telehealth consultation).
The virus infection can inflame the heart muscle (myocarditis) which can cause chest pain and heart failure which is a potentially serious illness. Blood tests and heart ultrasound tests may reveal the cause. Treatments to prevent heart failure are well known but, as yet, we do not know the best antiviral treatment. We think that early, aggressive and appropriate, treatment to prevent heart failure due to myocarditis will be the best approach.
General advice for those with known or suspected heart disease:
- Seasonal Influenza (‘Flu’) vaccinations should be continued.
- Heart Medications should generally be continued unchanged. Stopping or reducing usual treatment is more likely to cause not avoid a problem – particularly drugs to treat high blood pressure (Hypertension) and Heart Failure. There have been reports that certain drugs (Angiotensin Converting Enzyme (ACE) inhibitors and Angiotensin Receptor Antagonists (ARBs/ARAs) can make Corona virus infection worse- we think that the known risks of stopping these drugs outweighs the possible risks.
- Remember any infection can have effects on the heart and circulation and these effects are much worse in those with more severe heart conditions. Contacting your family doctor early on is advisable so they and we can jointly manage the situation as well as possible.
Changes to our Consultations in the Consulting Rooms:
- We are deferring routine consultations so we can pivot our efforts to seeing new patients with acute known or suspected heart disease to minimise the pressure on our overextended hospital system.
- We have a 2-part patient screening program in place. The RPAH Medical Centre Management Team is screening everyone entering the building. All of patients are being screened again on arrival at our reception desk for any symptoms of illness.
- We are ensuring physical separation of patients in the waiting room. We are avoiding or minimising accompanying persons.
- We are running a strictly Just in Time protocol so patients are dealt with as promptly as possible and leave the practice as soon as they can.
Telehealth Consultations: by phone call or video are being used to continue the care of patients for whom this is a substitute for an in office/clinic visit. We have best in class remote working technology which allows our Cardiologists to work from wherever they are.
Multi-Specialist and Multidisciplinary Virtual Case Discussions: This is standard practice in our group, and we have adapted it to have these discussions offline to improve efficiency while maintaining quality.
Remote Implanted Device care: We already have one of Australia’s most extensive programs to look after those with pacemakers and defibrillators from home. Previously this has been a supplement to usual care but now it is our first line.
In-office implanted device programming: Many of the implanted cardiac device companies have reduced or stopped in-clinic checks – for those patients who need this and cannot wait until the current crisis has passed, we will bring them in to the office and work with Cardiac Electrophysiologists and Cardiac Technicians to make changes in device settings where essential.