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Coronavirus (COVID-19) guidance for Scottish Adult Congenital Cardiac Service (SACCS) patients

Current guidance in relation to coronavirus and how it may relate to you

The following information relates only to your congenital heart disease – not any other health conditions you may have.

Whilst it is expected that many people will catch the virus over the course of the coming weeks and months, the risk of becoming seriously unwell as a result is low, particularly for children and young adults. However, as this virus is new, we do not yet know whether patients with an underlying congenital heart condition will be at any increased risk from the virus.

If you display worsening symptoms of COVID-19: It is important you seek advice early by calling NHS 24 on 111 and telling them about your heart condition.

You should continue your usual medications unless told otherwise by a health professional. If you are admitted to hospital, please ensure the SACCS team is informed.

Advice for patients with chronic heart disease

The UK and Scottish Governments have stated that patients with ‘chronic heart disease’ are likely to be at risk of severe illness from coronavirus.

Whilst technically all patients with a congenital heart condition and those with aortopathies affecting heart valves and function have ‘chronic heart disease’, it is likely that most of you will be at no greater risk than the general population. This is because your condition may be mild or because your heart functions well even if there are ongoing issues. For those of you who fall into this category, including patients with patent foramen ovale (PFO) - we advise following the recommendations for the entire population on hand washing and social distancing.

Advice for those considered extremely vulnerable patients who are at increased risk

Patients with severe forms of congenital heart disease and/or who are treated for worsening heart function may be at increased risk of becoming seriously unwell from coronavirus. Your heart may not cope as well if you catch coronavirus. If, at any point, you think you have developed symptoms of coronavirus, such as a new, continuous cough and/or high temperature (above 37.8 °C), seek clinical advice by phoning the NHS on 111. Do this as soon as you get symptoms.

Patients in the following groups should adopt shielding measures for at least 12 weeks - this means taking all measures possible to avoid catching coronavirus, and avoiding any face-to-face contact:

  • Fontan or single ventricle circulation (one pumping chamber)
  • Low blood oxygen levels so-called cyanosis (oxygen saturations below 92%)
  • Systemic right ventricle (the right pumping chamber is the main supply of blood to your body) – you have had a Mustard or Senning operation or have congenitally corrected transposition of the great arteries.
  • Heart failure or take regular medication to improve heart function
  • Pulmonary hypertension or Eisenmenger syndrome
  • Di George syndrome (also called 22q11 microdeletion or velo-cardio-facial syndrome)
  • Pregnant women with heart conditions

Supporting pregnant women with heart conditions

The government guidance states that pregnant women with significant heart disease, whether congenital or acquired, should also regard themselves as extremely vulnerable also and follow the advice above on shielding.

Members of the team who care for women with heart disease will review each individual case and plan follow-up. 

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

ACE inhibitors (end in -pril) and angiotensin II receptor blockers (end in -sartan)

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.

Somerville Foundation Heart Helpline

For confidential heart-to-heart, help with mental health and well being support, staff from the Somerville Foundation are available to speak on 0300 015 1998.

Where you can get more information

If you are unsure if you fall into any of these categories, please contact the SACCS team in the usual way (email: saccsnurse@gjnh.scot.nhs.uk, phone: 07795 953 070).

NHS Inform has advice and guidance on social distancing, self-isolation and shielding:

www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19

If you are having a non COVID-19 medical emergency, dial 999.

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   enquiries@gjnh.scot.nhs.uk        Hospital Switchboard 0141 951 5000