ABSTRACT
Background: Non-invasive cardiac imaging is an important part of a patient's safe and effective investigation for ischaemic heart disease. In the midst of the COVID-19 pandemic, concerns were expressed about the close proximity necessary for these investigations and the aerosol-generating nature of stress tests, limiting access to these vital investigations. Aim: To evaluate the impact of COVID-19 on cardiac stress investigations. Methods: We analysed Medicare Australia data for exercise stress tests (EST), exercise or pharmacological stress echocardiography (ESE), CT coronary angiogram (CTCA), and exercise or pharmacological nuclear perfusion studies during the peak pandemic years of 2020 and 2021 and compared to data pre-COVID-19 in 2019. Results: When compared to pre-pandemic statistics, the COVID-19 pandemic resulted in a 44 percent drop in all non-invasive stress examinations. Both EST and nuclear perfusion services saw the greatest reductions, with 89% and 33% reductions, respectively. CTCA services, on the other hand, increased by 30%, while stress echocardiography remained stable. Discussion: This study's discovery of significant reductions in non-invasive stress investigations for ischaemic heart disease is alarming. While non-pandemic factors must be taken into account, the pandemic's enormous influence on patient engagement with healthcare services, as well as reduced access to non-invasive tests, cannot be overstated. Longitudinal studies are required to understand the impact of fewer investigations on the incidence and prevalence of ischaemic heart disease in Australia as a result of COVID-19.