Virtual Care Up, Stethoscope Tests Down: Experts Concerned About Risk of Undiagnosed Heart Valve Disease

TORONTO, July 7, 2021 /CNW/ - Although many Canadians have been seeing their GPs virtually since March 2020 and intend to continue with virtual care for non-emergency appointments, three-quarters of respondents aged 25 and older to a national survey released today, believe the virtual visit is not as effective as in-person appointments in discovering new or worsening symptoms.  61% of those surveyed say they have not had a stethoscope check, a key diagnostic tool for uncovering heart valve disease, for more than one year.

"We have several factors converging that stand to result in a potentially significant health issue: an increase in virtual care during the pandemic and for the foreseeable future, too few stethoscope tests, and an aging population with very low awareness about heart valve disease symptoms who frequently discount symptoms because they often mimic the general signs of aging," says Dr. Charles Peniston, Cardiovascular Surgeon, former Division Head and Medical Director, Southlake Regional Health Centre and Chair of Heart Valve Voice Canada.

The survey, commissioned by Heart Valve Voice Canada (HVVC), a national non-profit patient advocacy organization that works to improve the health and quality of life of people living with heart valve disease, was conducted through Leger's online panel of 550 Canadians aged 25-plus, found:

• 26% of respondents report they had their last stethoscope check up within a year prior to the pandemic; for over a third (35%), it has been over 2 years
• Those who did not transition to virtual appointments during the pandemic are more likely to report they had a stethoscope check during the pandemic (34%) as compared to those who transitioned to virtual appointments (21%)
• Ontarians are least likely to have received a stethoscope check during the pandemic (19%)

"Virtual care plays an important role in healthcare delivery, but it has its shortcomings. We've got to help Canadians balance the benefits and ease of virtual care with also making sure to have their heart listened to. This is especially important when you factor in population health studies which show the prevalence of heart valve disease and the fact that many people with heart valve disease do not have symptoms. A stethoscope test arms GPs with that incremental knowledge," Peniston adds.

The survey also found:

• Two in five (44%) agree that COVID-19 and the resulting lack of regular appointments has increased their worry that a medical ailment may have been missed or undiagnosed. This concern is highest among Ontario respondents (56%) as compared to the rest of Canada (36%)
• One in three are still hesitant to visit their GP's office or to go to ER because of the pandemic
• Atlantic Canada respondents are most hesitant to visit their GP's office or the ER (58% vs. 32% rest of Canada)

Heart valve disease is a common, serious, but treatable condition that affects approximately 1.1 million people in Canada.  A first of its kind population-based study, aimed specifically at the community detection of heart valve disease found over 50% of newly detected cases of valve disease in a population that did not have symptoms of the disease. It revealed that more than half of persons with heart valve disease in the general population were not detected and thus do not know they had the disease.¹ If diagnosed and treated early, people can return to a good quality of life. Detection of heart valve disease involves identifying a heart murmur using a stethoscope followed by an echocardiogram to confirm the diagnosis.

In addition to its Symptom Tracker, HVVC recently unveiled a Virtual Appointment Guide designed to help Canadians and their caregivers identify and convey potentially concerning symptoms during virtual appointments and bring potential warning signs to the attention of their healthcare provider or in the case of an emergency, encourage patients to go to their local hospital Emergency Department. With an increase in caregivers across Canada, one of the Virtual Guide's Top Tips is the suggestion Canadians talk about their health with someone they're close to.

Established in 2018 Heart Valve Voice Canada is a national non-profit patient advocacy organization that works to improve the health and quality of life with people living with heart valve disease.

Editor's Notes regarding surgical advances and available patients who underwent procedures during the pandemic:

While the pandemic has had an unprecedented global effect on health care including the cancellation and delay of cardiac catheterizations, interventions, and surgeries, as confirmed by an international study of 60 centres around the world^2, treatment including innovative procedures continued for patients with heart valve disease including at Ontario's Southlake Regional Health Centre.

John Hartill, 85 from Bracebridge, ON is among the first patients in Ontario to undergo a breakthrough, minimally invasive TAVI (transcatheter aortic valve implantation) procedure using the carotid artery in the neck as an entry point instead of the usual femoral artery access in the groin. This innovation means more Canadians now have access to a potentially live-saving procedure.

Dave Smith, 63 from Mono Mills, ON visited his local ER during COVID-19. Diagnosed with severe aortic stenosis, he received a surgical aortic valve replacement (SAVR) during the pandemic, September 2020.

About the Survey:

An online survey of 550 Canadians who identify as current and future caregivers aged 25+ as well as non-caregivers aged 65-plus, was completed between June 4-6, 2021, using Leger's online panel.

1. The OxVALVE Population Cohort Study. Large-scale community echocardiographic screening reveals a major burden of undiagnosed valvular heart disease in older people: the OxVALVE Population Cohort Study - PubMed (nih.gov)
2. Response of Cardiac Surgery Units to COVID-19. An Internationally Based Quantitative Survey Mario Gaudino, Joanna Chikwe, Irbaz Hameed, N. Bryce Robinson, Stephen E. Fremes, Marc Ruel. Originally published11 May 2020

SOURCE Heart Valve Voice Canada

For interviews including with patients who received heart valve procedures during COVID-19, contact: Gabby Nobrega [email protected] 416.930.9756; Katherine Clark [email protected] 416.453.3288