key: cord-0075720-3w9hjwzf
authors: nan
title: Who Knows What the Future Brings
date: 2021-03-03
journal: Heart Lung
DOI: 10.1016/j.hrtlng.2020.08.019
sha: 2a26935e56ed70e6cb8c8601742b96507e17d605
doc_id: 75720
cord_uid: 3w9hjwzf

nan

Who knows what the future brings A number you may be remarkably familiar with is 6.2 million. Another number is >8 million. These represent the number of people in the United States > 20 years old with heart failure from 2013 to 2016 and the number of people 18 years old expected to have heart failure by 2030 respectively. 1 Guo et al. in Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19) described patients with underlying heart disease and elevated troponin T (TnT) levels having a 69.44% mortality level compared to 7.62% for patients without heart disease and elevated troponin levels. 2 Another study Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases published in JAMA Cardiology identified frequent infection of SARS-CoV-2 in the myocardium (61.5%) but not always meeting the criteria for acute myocarditis, warranting additional long term studies. 3 I remember being surprised when I read the Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered from Coronavirus Disease 2019 (COVID-19) article published in JAMA Cardiology. Putman et al. (2020) detailed the study of 100 patients in Germany who recovered from COVID-19, most of which recovered at home (67%) and a third (33%) who were hospitalized. A cardiac magnetic resonance image was performed after the patient was a minimum of two weeks post diagnosis (average 71 days) and free of respiratory symptoms. Of those patients, 78% showed myocardial changes with 60% cardiac inflammation. This was similar in the hospitalized and patients who recovered at home. Patients demonstrated lower ejection fractions and higher volumes compared to matched controls. 4 What are these studies telling us as heart failure nurses? Our patients with heart failure are fragile and this fast and easily spread COVID-19 virus can be deadly. This virus can infect even healthy hearts and the long-term effects are unknown. Patients who recovered from the COVID-19 even without cardiac symptoms are likely to experience myocardial changes even months after recovery. Your skills to identify early signs of heart failure are critical in populations previously not at risk.

It is important now more than every to be vigilant about protecting our heart failure patients as well as others from COVID-19. Model and educate on the Centers for Disease Control and Prevention recommendations:

Wash your hands often using soap and water for 20 seconds or using hand sanitizer with at least 60% alcohol.

Maintain social distancing of at least six feet when with other people. Avoid contact with people outside your home when possible.

Wear a mask covering your nose and mouth when in public even when social distancing. (This does not apply to children under the age of 2 or those incapacitated and unable to remove their own mask.)

Cough or sneeze into your elbow or a tissue and wash or sanitize your hands afterwards.

Clean and disinfect high touch areas frequently to decrease the spread of germs. 5 When I think about the 8 million people in 2030 expected to have heart failure, I hope through our efforts to decrease the incidence of heart failure and prevent the spread of COVID-19, we can have an impact on that number.

Tsao Connie W. Heart Disease and Stroke Statistics-2020 Update: A Report From the American Heart Association

Cardiovascular Implications of Fatal Outcomes of Patients With Coronavirus Disease 2019 (COVID-19)

Association of Cardiac Infection With SARS-CoV-2 in Confirmed COVID-19 Autopsy Cases

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)

How to protect yourself & others

She is a Certified Heart Failure Nurse, Cardiac Vascular Certified Nurse, Adult Clinical Nurse Specialist and Nurse Executive Advanced Certified. She is currently working at the University of Pittsburgh Medical Center Children's Hospital as the Director of Cultural Excellence