Yesterday the British Congenital Cardiac Association has published comprehensive information about adults, teenagers and children with congenital heart conditions.
They have set out guidance for the group of patients that they feel are in the higher risk category if they were to catch Coronavirus, bringing advice in line with the Government advice for anyone with complex heart conditions. https://www.bcca-uk.org/pages/news_box.asp?NewsID=19495710
They have advised anyone with a single ventricle heart condition to reduce social contact as they are in the higher risk group. That does not mean that they will all be seriously ill if they catch the virus but it does mean that a small percentage of them may have a tough time recovering.
Q: What does reducing Social Contact mean?
A: Social distancing is avoiding large crowds in places like school, college, university or work. Avoid going out and socialising with family and friends.
Avoid contact with anyone who is displaying symptoms of coronavirus (COVID-19). These symptoms include high temperature and/or new and continuous cough
We know that some of these measures will be challenging but they are all set out to reduce the risks for anyone with a single ventricle heart condition catching the virus.
Q: Is there any advice for siblings, parents or partners of people with a single ventricle heart condition?
A: To date there is only a little advice for anyone living in the same household as someone with a single ventricle heart condition.
Young siblings will be off school, college or university from the end of the day on Friday. They need to be mindful about washing their hands, even at home. If they go out and about they need to wash their hands as soon as they come home and the advice is to change out of the clothes they have been wearing outside.
There is general guidance for other people living in the same house but who have to go to work. Change your clothes when you reach home and wash hands and or use sanitizer after you have changed.
If any member of the household shows signs of Coronavirus they need to follow NHS guidelines. https://www.nhs.uk/conditions/coronavirus-covid-19/
‘If you live with someone who has a long-term condition or has a weakened immune system, try to find somewhere else for them to stay for 14 days.
If you have to stay at home together, try to keep away from each other as much as possible.’
If you have had to stop work to look after a child with a heart condition it is important to talk to your employer about the support they will give you. Government are changing their guidelines every day about the support they will offer to anyone who has had to stay away from work. https://www.gov.uk/government/news/coronavirus-covid-19-guidance-for-employees-employers-and-businesses
Q: Attending Clinics
A: Children, teenagers and adults with complex heart condition need to have their condition monitored in the normal way. It is important to attend planned outpatient appointments and cardiac tests. If your appointment has been cancelled the cardiac team will contact you.
If you are showing signs of Coronavirus do not attend your clinic appointment. Ring the cardiac team to cancel the appointment and to ask for advice.
Q: ACE Inhibitors or angiotensin receptor II antagonists – set out by the BCCA.
Many patients with congenital heart disease or heart failure may be on ACE inhibitors (e.g. captopril, lisinopril, enalapril) or angiotensin receptor II antagonists (e.g. losartan). The British Cardiovascular Society, British Society for Heart Failure and European Society of Cardiology Council on Hypertension have said that there is no clinical or scientific evidence to suggest that treatment with an ACE inhibitor should be discontinued because of COVID-19. Stopping these medications may cause worsening of their heart condition.
Q: Is there any advice if we are prescribed Aspirin?
A: The BCCA recommendation is that patients who are taking aspirin continue on their treatment unless advised differently by their cardiac team.
Q: Use of paracetamol versus ibuprofen
A: Although there is as yet no firm evidence, patients should use paracetamol rather than ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) to control fever and pain. The use of aspirin is different and addressed above.
Q: What do you do if someone with a single ventricle heart condition shows signs of Coronavirus?
A: If you have these symptoms – dry cough and or temperature greater than 37.8 or you feel hot to touch.
Follow the guidance as laid out on the NHS page- https://www.nhs.uk/conditions/coronavirus-covid-19/
Only contact 111 if you are unable to cope with your symptoms at home, trust your instincts about how you feel, but if you feel worse over the next few days call 111 and tell them you have a congenital heart condition. The 111 service are the best people to advise how you can get help.
Do not self-present to your cardiac centre as hospitals have a plan for where patients with the virus are admitted.
Our NHS is extremely skilled in looking after sick patients so for any medical professionals you interact with make sure you have a copy of your last clinic report to show to them. It will give details of your diagnosis and contact information for your specialist team.
It is also important that you inform your Cardiac Specialist Nurse so they can link with the specialist infection team looking after you or your child.
Q: How will children with Coronavirus and a heart condition be looked after at the hospital.
A: LHM has been given an opportunity to look at the plan for how children with complex conditions will be cared for if they become ill with Coronavirus, and need to be in the hospital. Obviously, they will need to be isolated from other children but the plan is that a parent or carer will be isolated with them. We hope that this reassures parents who are worried that they might be separated from their children. NHS Guidance is set out in this document: