• March 25th, 2020

Coronavirus Advice - Adult Patient Advice (ACHD)

Updated 24/03/2020 at 16.00

Changes to last update: more stringent advice to self-isolate for patients with more complex heart conditions (see section ‘Are you at increased risk from coronavirus and what should you do if you are?’).

In light of the coronavirus pandemic we are regularly reviewing how we work in the Paediatric Cardiology service in Leeds. Our goal is to keep the service running for those who need it whilst keeping our well patients as safe as possible.
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.

General government advice is here

As from 24/3/20 the advice from the Government, for all citizens, is to stay at home and:

Only go outside for food, health reasons or work (where this absolutely cannot be done from home)

Stay 2 metres (6ft) away from other people

Wash your hands as soon as you get home

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

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 at here

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

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

The government’s advice on the use of ibuprofen to treat symptoms of coronavirus infection is available at https://www.gov.uk/government/news/ibuprofen-use-and-covid19coronavirus

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 are likely to 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

For these patients we recommend following the government guidance for those who are extremely vulnerable from the virus, which strongly advises staying at home at all times and avoiding any face-to-face contact for a period of at least 12 weeks. Full details are available “Here”: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19.

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

Until further notice there will not be any routine in-person outpatient appointments. Instead, we will review patients over the phone or in a video call. Patients will be contacted directly by a doctor or nurse (appointments will not be sent out in advance).

We will try to minimise requesting tests such as ECGs, echo scans and blood tests, but will arrange these if they are necessary. For any one who does need to be seen in person a hospital appointment will be arranged.

If you have any concerns regarding your heart you should contact the Adult Congenital Heart Disease specialist nurses in the usual way (0113 392 8154,“Email”: leedsth-tr.achdnurse@nhs.net

Pregnant women with heart conditions

For general advice on coronavirus in pregnancy please visit the Royal College of Obstetricians and Gynaecologists website here

On 21/3/20 the government published guidance for groups of people felt to be extremely vulnerable to coronavirus, strongly advising staying at home and avoiding any face-to-face contact for at least 12 weeks. Pregnant women with significant heart disease, whether congenital or acquired, are included as one of these groups MORE INFORMATION HERE.

Members of the team who care for women with heart disease will review each case to decide on the best course of action for each individual. In some cases it will be possible to manage pregnancy and plan delivery through phone or video consultations. In other cases it may still be necessary to arrange visits to hospital. We will contact you to discuss the most appropriate plan.

Planned operations and keyhole procedures

We continue to perform urgent cardiac surgery and keyhole procedures but are not currently able to perform any routine surgery or keyhole procedures.

Updated 24/03/2020