1. Can cardiac patients, in particular, suffer from coronavirus infections?
Coronavirus infection is a highly contagious respiratory illness mainly affecting the lungs, but it can highly cause severe systemic infection and can involve other organs of the body including heart, kidneys, liver, brain, etc. Our cardiac patients are already suffering from cardiac comorbidities and have compromised heart functions and in many such cases, the lung/liver/kidney functions are also jeopardized. So, they always have a high risk of developing severe complications out of coronavirus infection.
2. When to suspect Coronavirus infection in a cardiac patient?
Coronavirus infection can itself lead to cardiac problems like viral Myocarditis and heart failure and can also lead to heart attacks. Sometimes, patients’ symptoms of acute heart attack or heart failure can be misleading and confusing as patients with coronavirus severe infection can also have similar symptoms. So, it is important to correlate with previous symptoms of fever, cough, headache, running nose and also take proper travel/contact history with other corona positive patients. Chest X-ray & Chest CT-scan sometimes provide useful insights with some typical radiological appearances.
3. How to confirm and treat such patients?
Confirmation is obviously blood testing initially for antibody detection as now available with rapid kit tests. Further confirmation is throat swallow testing. Treatment depends on the severity of symptoms and many require additional cardio-respiratory support or ventilators. Some drugs are available although not fully proven about their efficiency.
4. Will you recommend Hydroxychloroquine as a protective measure in your heart patients?
Not at all. Rather cardiac patients should avoid Hydroxychloroquine as this medicine can cause dangerous arrhythmias and can be fatal. HCQ should be restricted to limited groups who are at the high ride of infection as per ICMR guidelines and even they should do an ECG and consult with a doctor before starting HCQ.
5. What about the treatment of other cardiac patients, who do not have coronavirus infection?
In the present scenario, our hospital and all other centres are handling all sorts of Cardiac Emergencies as before. But considering lockdown we advocate that those patients who are a chronic treatment and presently stable should stay at home, continue their usual treatment and restrictions and avoid exposure to the hospital environment unless there is some serious issue.