To continue to provide care for patients during the COVID-19 outbreak, many doctors are offering telemedicine appointments, including Dr. Ernst von Schwarz, a board-certified cardiologist and medical director of the Southern California Hospital Heart Institute in Culver City.
“We started offering telemedicine appointments on March 26 for those who prefer to stay at home rather than come into the office,” said Dr. Schwarz. “However, our clinic remains open for in-person appointments and we take all appropriate protections for the staff and patients because their safety is our highest priority.”
Patients can call the Heart Institute to set up a telemedicine appointment with Dr. Schwarz, and the telemedicine appointment is done by phone or video conferencing. Telemedicine appointments are being conducted daily.
Telemedicine appointments are covered by Medicare and many insurers, Dr. Schwarz added.
“We know this can be a frightening time for patients,” he said. “We want to reassure our patients that they can call or come in because they will be seen.”
All elective procedures such as angiograms and pacemaker implantations have been temporarily canceled due to the COVID-19 outbreak, but can be done on an emergency basis at Southern California Hospital at Culver City.
Patients who have had an elective cardiac procedure canceled are called every two days to monitor their condition and are asked to come into the clinic if necessary.
In accordance with the latest guidelines by the Centers for Disease Control, the following safety procedures are implemented:
Dr. Schwarz said all patients with heart disease are encouraged to take extra precautions because they are at higher risk if they catch COVID-19. While the coronavirus mainly targets the respiratory system, the virus can affect the heart and cause inflammation that could lead to heart failure.
He cautioned patients to continue to take all medications. These include ACE inhibitors and ARBs (angiotensin II receptor blockers), which are prescribed primarily to treat high blood pressure and heart failure.
Although a few experimental studies with animal models have appeared to show that ACE inhibitors and ARBs may increase replication of coronavirus in the heart, these have not been shown in human studies or in COVID-19 settings, according to the American College of Cardiology and the Heart Failure Society of America.
The ACC, HFSA and the American Hospital Association all recommend patients continue to take the medications. As further research and developments evolve, the recommendation will be updated if needed, the groups said in a joint statement.
“Stopping these medications prophylactically would do more harm than good,” Dr. Schwarz said. “Patients should continue to take them. The only reason to stop would be in a confirmed case of COVID-19 or high suspicion of it.”