Mayo Clinic study finds uptick in chest pain searches online amid COVID-19, even as ED visits for heart problems drops

One of the big concerns reported in emergency departments across the country in the weeks and months after the COVID-19 pandemic began was around just how much their volumes dropped.

The big question: Just what happened to all the heart attacks? 

Mayo Clinic researchers may lend more evidence that patients were trying to avoid a trip to the emergency room. In a study published this week in JMIR Cardio, the researchers found a correlation between online searches for chest pain symptoms and reports of fewer people going to the emergency department with acute heart problems.

"This raises concern that people may have either misconstrued chest pain as an infectious symptom or actively avoided getting care due to COVID-19 concerns," said Conor Senecal, M.D., a Mayo Clinic cardiology fellow and the first author on the study, in a statement.

The study also tracked online searches for general COVID-19 symptoms such as "cough" and "fever" and saw while those searches were numerous after the start of the pandemic, they dropped off. Searches related to "chest pain" continued at a high clip through the end of May. 

"Some of the rising searches, such as 'home remedies for chest pain' and 'natural remedies for chest pain'―both of which had a greater than 41 times increase―were surprising and provide insight into patients' possible avoidance of health care contact during the pandemic," Senecal said. 

This study lends weight to previous analyses which have raised the possibility of an excess of deaths from acute heart problems with experts patients were avoiding hospitals for fear of contracting COVID-19.

The study comes on a the heels of another piece of research published in JACC: Clinical Electrophysiology which found patients with out-of-hospital cardiac arrest were less likely to get bystander CPR, experience delayed EMS response time and have an overall reduced chance of surviving. Similarly, another study published this week in JACC: Cardiovascular Interventions which looked at data from ambulance calls in the Denver area. That study found that while the overall calls for help dropped in the months when individuals were urged to stay at home, the number of people dying from cardiac arrests went up.