Online searches for 'chest pain' rise, emergency visits for heart attack drop amid COVID-19

Mayo Clinic researchers looked at Google Trends data for Italy, Spain, the U.K. and the U.S., reviewing search terms such as "chest pain" and "myocardial infarction" (heart attack). The study spanned June 1, 2019 to May 31. Prior to the pandemic, those searches had relatively similar volumes to each other. The expectation would be that the frequency of heart attacks would stay the same or even rise in this setting. However, at the onset of the COVID-19 pandemic, searches for "myocardial infarction" dropped, while searches for "chest pain" rose at least 34%.

Conor Senecal, M.D., a Mayo Clinic cardiology fellow in Rochester, is first author on the study, which is published in JMIR Cardio.

"Interestingly, searches for 'heart attack' dropped during the same period of reported reduced heart attack admissions, but surprisingly, searches for 'chest pain' rose," says Dr. Senecal. "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."

To differentiate between Google searches for general COVID-19 symptoms, the study also tracked queries for "cough" and "fever." Initially, these searches were numerous, but then dropped off. The searches related to "chest pain," however, stayed at a high volume through 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," says Dr. Senecal.

He adds that while concern over COVID-19 infection is warranted, if people are experiencing chest pain, they need to seek medical evaluation. This can be done in a safe manner that will help them avoid the consequences of delayed cardiovascular care.

The study underscores the need to find additional ways to educate patients that emergency conditions such as a heart attack and stroke can be safely cared for, even during the COVID-19 pandemic. People can be prepared by learning the common symptoms of a heart attack and being aware that some symptoms can vary between men and women.

Also contributing to the study are Amir Lerman, M.D., senior author, and Rajiv Gulati, M.D., Ph.D. -- both Mayo Clinic cardiologists.