• Ruth H Arnold, Philip A Tideman, Gerard P Devlin, Gerard E Carroll, Alex Elder, Harry Lowe, Peter S Macdonald, Paul G Bannon, Craig Juergens, Mark McGuire, Justin A Mariani, Sean Coffey, Steven Faddy, Alex Brown, Sally Inglis, and Wang William Y S WYS CSANZ Indigenous Health Council, Princess Alexandra Hospital, Brisbane, and University of Queensland, Brisbane, QLD, Australia..
• Orange Health Service, Orange, NSW, Australia. Electronic address: ruth@coldhearts.com.au.
• Heart Lung Circ. 2020 Jul 1; 29 (7): e88-e93.

The ChallengesRural and remote Australians and New Zealanders have a higher rate of adverse outcomes due to acute myocardial infarction, driven by many factors. The prevalence of cardiovascular disease (CVD) is also higher in regional and remote populations, and people with known CVD have increased morbidity and mortality from coronavirus disease 2019 (COVID-19). In addition, COVID-19 is associated with serious cardiac manifestations, potentially placing additional demand on limited regional services at a time of diminished visiting metropolitan support with restricted travel. Inter-hospital transfer is currently challenging as receiving centres enact pandemic protocols, creating potential delays, and cardiovascular resources are diverted to increasing intensive care unit (ICU) and emergency department (ED) capacity. Regional and rural centres have limited staff resources, placing cardiac services at risk in the event of staff infection or quarantine during the pandemic.Main RecommendationsHealth districts, cardiologists and government agencies need to minimise impacts on the already vulnerable cardiovascular health of regional and remote Australians and New Zealanders throughout the COVID-19 pandemic. Changes in management should include.Copyright © 2020 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

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