COVID-19, the disease caused by the new coronavirus, has put much of life as we know it on hold. For many people, including those with heart disease or other conditions, the virus also has delayed some tests and procedures. As the number of COVID-19 cases begins to drop in communities, hospitals and clinics are starting to resume non-urgent testing and procedures. But it’s not business as usual. They are reopening in ways to protect you and the people who will care for you. While you wait, watch for any signs that your condition is getting worse. If your symptoms change, call your health care team right away. This information could affect the decision to postpone a test or procedure. Talk to your health care professional if you have concerns.

Why Has My Test or Procedure Been Delayed?

To handle the expected surge of patients with COVID-19, most hospitals and practices have postponed non-urgent tests and procedures. 

Many of these decisions have been guided by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS). 

Putting off some tests and procedures during this crisis can help:

• Reduce the spread of COVID-19 overall by having fewer patients and visitors
• Protect you and care teams from exposure to people who may be carrying the virus
• Conserve medical supplies, so they can be used to care for patients who are severely ill
• Ease the strain on the health care system to help care for people with COVID-19 and other emergencies, including heart attacks and strokes 

Postponing a test or procedure may make you feel uneasy, especially if it has been on the calendar for a while. You may be worried about how this delay might affect your health or options for care. 

Rest assured that: 

• Tests or procedures are being delayed only if the condition is not considered urgent or life-threatening
• Your health care team will do all they can to help you manage your condition and any symptoms you have during this time.

Which Tests and Procedures are Delayed?

Not all tests, procedures or surgeries are being postponed. To make this decision, your care team may consider several factors including: 

• The degree of your symptoms and heart condition: How bad, or severe, are they?
• Whether the test or procedure needs to be done right away: A procedure unlikely to affect your care or situation over the next several months is not considered urgent 
• Whether the test or procedure requires the use of personal protective equipment or additional testing

“Any decisions about the timing and urgency of cardiac tests and procedures should be made by you and your care team.”
— Ty Gluckman, MD, FACC, medical director, Providence Heart Institute, Portland, Oregon

What is the difference between tests and procedures that can be delayed vs. those that need to be done right away?

Can be delayed Non-urgent or elective	Needs to be done right away Urgent, essential, or emergency care
A delay is unlikely to affect your care or result in harm over the next several months   Examples include:Routine tests, such as echocardiogramsProcedures for patients who have mild symptoms or who are managing their disease well	Must be done at once or within a short time to reduce risk of more serious, worse outcome Examples include:Heart attackLoss of consciousnessStrokeWorsening shortness of breath

 

What Happens as Tests and Procedures Resume?

As the number of COVID-19 cases starts to drop in your community, many hospitals and clinics will begin to resume non-emergency heart tests and procedures. 

They will do so carefully while working with public health officials to keep a close eye on how things are going. They also will take steps to protect you, other patients, and health care workers while you receive care during the pandemic. 

These safety measures may include:

• Allowing only patients (no visitors) to come to the hospital or clinic
• Requiring patients and health care workers to wear masks
• Screening or testing patients for COVID-19 before they are OK’d for a procedure or test
• Providing care to patients with COVID-19 in a dedicated part of the hospital 
• Screening or testing health care workers involved in your care for COVID-19

Resuming tests and procedures will likely happen in phases to help make sure that patients with COVID-19 and those without it are getting the right care at the right time. Health organizations, including the American College of Cardiology, issued guidance on this recently. 

We are still learning about COVID-19, and experts warn that new waves of the disease may lead to changes in your treatment plan. That is why it’s so important to work with your health care team to figure out which cardiovascular tests and procedures don’t need to be done right away.  

Decisions about your test or procedure will depend on how you are doing and local COVID-19 disease activity.

What You Can Do

Talk with your care team if you have concerns about waiting to have a test or procedure done. Often a phone call or telehealth visit to discuss your concerns can provide some peace of mind. It can also reassure you that you will get the care you need when you need it. 

Just like you would do before the COVID-19 pandemic:

• Take your medications as directed—don’t make any changes without talking to your care team first
• Watch for any new symptoms or signs that your heart condition may be getting worse and call your health professional to let them know
• Keep up with healthy habits including exercising regularly, and eating vegetables, fruits, and unprocessed foods
• Know how to contact your health professional or call 911 in an emergency.