Fatal heart attacks have surged in Australia. Here’s why

Aisha Dow

January 21, 2023 — 5.00am

More than 10,200 Australians died of ischemic heart disease in the first eight months of 2022 – that is about 17 per cent higher than would be expected in a normal year.

According to an analysis of mortality data by the Actuaries Institute, about 2300 deaths from ischemic heart disease over 2021 and 2022 are considered excess, which means they fall outside the expected natural range.

“Deaths with ischemic heart disease really involve blockages of the blood vessels. And when you have blockages in the blood vessels you then damage heart muscle, and your heart fails, and it can go into cardiac arrest, which means that it essentially stops,” said Professor Steve Nicholls, director of the Victorian Heart Hospital.

Leading heart disease experts say the death statistics are concerning but not surprising. For years, cardiac deaths have been the leading cause of death in Australia. The pandemic has only increased the risk factors.

“It’s kind of the last straw,” said Professor Tom Marwick, director of the Baker Heart and Diabetes Institute.

“The camel’s back was straining under the burden of risk factors, and then we have an infectious disease on top with a bunch of inflammation, hey presto we get an increase of cardiovascular events.”

Coronavirus has been implicated in an increased risk of cardiovascular problems, with a study published in the prestigious science journal Nature finding that rates of heart attacks and stroke were substantially higher in military veterans who had recovered from COVID-19, compared to those who hadn’t had the disease.

A recent Australian study also found hospitalisations from myocarditis (inflammation of the heart muscle) and pericarditis (swelling of the membrane surrounding the heart), pulmonary embolism, heart attack and stroke were significantly more frequent after COVID‐19.

While rare cases of myocarditis and pericarditis have been linked to COVID vaccines, the Therapeutic Goods Administration says most people get better within a few days. Experts say vaccination is considered especially crucial for those with risk factors for cardiovascular disease.

The number of excess deaths in Australia surged to 15,400 in the first part of 2022.

While the majority of these deaths were from COVID-19, the nation is also seeing significantly elevated rates of deaths from diabetes, strokes and ischemic heart disease.

Cardiologists believe the increased deaths from ischemic heart disease are likely linked to the damaging effects of COVID, but also delayed diagnoses, prevention and treatment through the pandemic.

‘The camel’s back was straining under the burden of risk factors, and then we have an infectious disease on top ... hey presto we get an increase of cardiovascular events.’

Professor Tom Marwick

Nicholls, a cardiologist, said the heart wards in public hospitals were very busy.

“So it’s not just that a lot of people are dying, but we’re seeing a lot of people at a whole range of different stages of [heart] disease,” he said. “One of our concerns early on in COVID was that we were going to miss people early [in heart disease] and then people would tend to present later.”

Nicholls said everyone should talk to their GP about getting a heart health check.

“We know the major risk factors for heart disease. We know that’s high blood pressure, it’s high cholesterol, it’s diabetes, it’s smoking, it’s obesity, and it’s a family history. You can’t do anything about your family history, but you can do something about everything else.”

Dr Amanda Buttery, the Heart Foundation’s clinical evidence manager, said there had been a reassuring surge in 2022 in the number of Australians getting heart checks, following marked decreases through lockdowns and the first Omicron wave.

November 2022 saw a record number of heart health checks claimed.

However, Buttery said the foundation remained quite concerned about mounting international evidence of a connection between long COVID and cardiovascular disease.

“COVID-19 infection worsens pre-existing heart conditions, and increases the risk of developing more than 20 heart conditions including heart attack, blood clots, heart failure and stroke,” she said.

“COVID infection in Australia grew substantially in 2022. We are yet to see the full impact of this in health data.”

The Actuaries Institute, the body that represents the actuarial profession in Australia and which evaluates and manages the financial risks faced by businesses, has also cited delays in emergency care caused by pressure on hospital systems as a possible factor in the country’s excess deaths. In Victoria, at least 33 people died from emergencies that were linked to delays in answering triple-zero calls or lengthy ambulance waits between December 2020 and May 2022.

However, Professor Tom Marwick said data he had seen on heart attack mortality suggested that may not be as big a factor as expected.

“Surprisingly, it shows that the mortality is just the same as pre-COVID. In other words, for people that got to the hospital, the outcomes are the same. The issue is, of course, the people that didn’t get to the hospital and the people who missed care and are presenting with more progressive disease now.”

Marwick said he remains very concerned that many of those most at risk of a heart attack don’t have a regular GP. He said Melbourne’s west, which has been disproportionately battered by COVID-19 outbreaks, was also one of the hotspots for heart attack. The area has fewer GPs per person.

At least 17,717 Australians have died of COVID. There have been 14 deaths linked to COVID vaccines from more than 64 million doses administered in Australia. One of those was a fatal case of myocarditis in a young woman where an expert vaccine safety group concluded a COVID vaccine was likely related, alongside several other factors.