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10:47 AM

Don't Wait: Stroke, Heart Attack Still Emergencies, Doctors Say

During COVID-19 Pandemic, Experts Encourage Use of Telephone or Video Visits for Milder Symptoms, Calling 911 For Acute Symptoms

Doctors who treat stroke and heart attack patients are trying to find out why they have been seeing fewer patients with these life-threatening emergencies during the COVID-19 pandemic.

Is COVID-19 somehow preventing emergencies from happening? Or, are people ignoring symptoms and staying home instead of seeking the medical care they need?

Shlee Song, MD, Director of the Cedars-Sinai Comprehensive Stroke Center and Telestroke Program is leading a multi-center data collection study to determine the impact of COVID-19 on acute stroke care throughout Los Angeles county. Results are expected in June.

In the meantime, Cedars-Sinai experts say there are some symptoms no one should ignore.

Patrick Lyden, MD, professor of Neurology at Cedars-Sinai, says that signs of a stroke include the sudden onset of numbness on one side of the face or body, slurred speech or inability to walk in a straight line. This is easily remembered by the acronym BE FAST:

B – (sudden loss of) balance
E – eyes (vision loss)
F – face drooping
A – arm weakness
S – speech difficulty
T – time to call 911

Lyden says that neurologists treating stroke often say, "time is brain," meaning that the sooner patients seek care, the sooner they can be treated and spared from potential long-term brain damage.

"If you're having a stroke, you still need to come in, we are still here for you," Lyden said. "Time is still brain, and we still have great treatments. We can cure stroke. And we're here to keep doing that."

At Cedars-Sinai, patients with COVID-19 are kept separately from other patients, and all staff members are screened daily for COVID-19 symptoms. In addition, everyone is required to wear face masks.

The stroke team staff at Cedars-Sinai work closely with the Emergency Department to implement telemedicine techniques to evaluate and treat stroke patients while taking extra precautions to prevent exposure to the coronavirus.

Using a telemedicine camera, patients who come to the Emergency Department with stroke symptoms can be evaluated by a stroke specialist until their COVID-19 status can be established. Lyden says these precautions limit opportunities for transmission of the virus and could help save lives.

Michelle Kittleson, MD, PhD, professor of Medicine and a cardiologist in Cedars-Sinai's Smidt Heart Institute, says symptoms of a heart attack include chest discomfort, shortness of breath, palpitations, lightheadedness and fainting spells.

"If you're feeling these symptoms and you're not sure whether to go to the ER and risk being exposed to infection versus waiting it out at home, call your doctor," Kittleson said. "As physicians, we have a lot of great experience in teasing out the details of a patient's symptoms to triage whether the symptom is dangerous or not."