Trend In Acute Coronary Syndrome V (<45y)

Lessons from an undisclosed NHS Trust

Well, I’ve done a bit of digging and have found what was responsible for that pronounced peak of 3.2% of all admissions for those aged under 45 years that occurred during week 4 (w/b 23rd Jan) – it’s A&E admissions coded as Cardiac conditions - other non-ischaemia.

What is mighty interesting is the steady build in such admissions from mid 2019 onward, with a flurry during 2020 week 14 – 2020 week 22. Common conditions that would fall under this category are myocarditis, pericarditis, atrial fibrillation, ventricular fibrillation and all forms of bradycardia and tachycardia. In short we’re looking at infection and inflammation of the heart muscle and problems with conduction rather than ACS. If this is viral in origin then we're looking at evidence of a pre-2020 outbreak.

It’s worth noting that pulmonary embolism (PE) can induce cardiac issues like these and no doubt our clinicians will be able to elucidate. What I’m finding most puzzling is the decline in these conditions at a time wh…