• March 18th, 2020

Coronavirus Advice - Adult Patient Advice (ACHD)

In light of the coronavirus pandemic we are regularly reviewing how we work in the Adult Congenital Heart Disease service in Leeds.

The following incorporates guidance from the government and other sources such as the British Congenital Cardiac Association, and we will continue to update as the situation develops.

While it is expected that many people will catch the virus over the next few weeks to months, the risk of becoming unwell as a result is low, particularly for children and younger adults. We do not yet know whether patients with an underlying congenital heart condition will be at any greater risk from the virus.

If you or a member of your household think you may have coronarvirus

Symptoms that indicate possible coronavirus are a new continuous cough and / or a high temperature. If you or another member of your household have either of these symptoms it is important to follow the national guidance on self-isolation, available here https://www.gov.uk/government/publications/covid-19-stay-at-home-guidance/stay-at-home-gui”:dance-for-households-with-possible-coronavirus-covid-19-infection

If symptoms are serious, and cannot be managed at home, visit NHS 111 online (but only call NHS111 if you cannot get online).

If you are admitted to hospital inform the Adult Congenital Heart Disease specialist nurses (0113 392 8154, email leedsth-tr.achdnurse@nhs.net).

If you develop symptoms consistent with having the virus you should continue any medicines that you take regularly for your heart, because if they are stopped there is a risk of deterioration in your heart condition.

Ibuprofen should not be used to aid symptoms if coronavirus infection is suspected. Paracetamol can be used.

Are you at increased risk from coronavirus and what should you do if you are?

The government has stated that patients with ‘chronic heart disease’ are likely to be at increased risk of severe illness from coronavirus. Whilst technically all patients with congenital heart disease have ‘chronic heart disease’, in fact it is likely that most congenital heart disease patients are at no greater risk than the general population (for example because their condition is relatively mild or the heart functions well even if there are ongoing issues).

For such patients we advise following the government’s recommendations for the whole UK population on hygiene and social distancing, here
specifically the sections ‘What is Social Distancing’ and ‘Handwashing and Respiratory Hygiene.’

Some patients have more severe forms of congenital heart disease and so may be at increased risk of becoming seriously unwell from the virus. These groups include patients:

With a Fontan or single ventricle circulation

Who have cyanosis (low blood oxygen levels)

Who have had a Mustard or Senning operation

Who have heart failure / take regular medicines to improve heart function

With pulmonary hypertension or Eisenmenger syndrome

With Di George syndrome if the immune system is affected

Patients who are likely to be at increased risk are very strongly advised to make every effort possible to reduce the chance of getting the virus by following the guidance on social distancing referred to above.

Ideally, this includes working from home.

It is difficult to give advise on the level of risk for patients who have other underlying heart conditions but, as a general rule of thumb, if your outpatient follow up is planned for every 2 years, or less frequently, then your risk is likely to be similar to the general population.

Outpatient clinics

Currently, we are continuing to run outpatient clinics in Leeds.

However, consultants are reviewing individual cases and will decide whether consultations can be performed by telephone or video. In general we will use telephone or video consultations for high risk patients. We will be in touch if this applies to you, otherwise please attend in person.

Clinics in Hull have all been converted to telephone appointments.

If you are well but have other symptoms consistent with a viral infection, such as a runny nose, it will likely be sensible to delay and rebook a clinic appointment. Please contact our clinic clerks on 0113 392 2619.

Planned operations and keyhole procedures

The capacity to perform cardiac surgery in Leeds is already reduced to the point that we no longer have the capacity to perform elective operations. This means that for the foreseeable future only urgent surgery will be performed.

For now, we are able to continue to perform elective keyhole procedures. We will call patients the day before the planned procedure to enquire as to whether you or any household contacts have any symptoms that might mean we should reschedule.

Updated 18/03/2020