We are living in unprecedented times and coursing through the pandemic apprehensively but simultaneously learning a lot about the threat it poses to people with heart disease. It’s not only affecting public health, but also social and economic activities. Covid-19 is affecting the heart and those who have pre-existing heart disease have higher incidence of severe infection thus making it double-edged threat. So, taking care of our heart right now is more important than ever.
Risk of getting Covid infection might be similar for all but once get infected, heart patients have higher chance of acquiring severe form of the disease. So those who are immunocompromised with associated heart disease are theoretically at the greatest risk. Other conditions of sick heart like heart failure, cardiomyopathy, and unrepaired congenital heart disease are at the highest risk.
Corona virus primarily affects the lungs but sometimes its impact seems to go beyond to involved multiple organs of the body. As a result, the heart also gets affected by multiple mechanisms. There might be direct injury or indirectly through cytokine storm (enhanced immune response) that leads to weakening of heart muscle, a condition called heart failure. Till now we have robust evidence favouring a high incidence of thrombosis (formation of blood clots) in severe infection causing leg swelling, clots in lungs and less commonly heart attacks and stroke. For these reasons, timely diagnosis and treatment of Covid-19 especially in high-risk patients are key to avoid these complications even death.
While recognising the covid-19 symptoms, one should also be careful about heart involvement. These symptoms include sudden onset breathlessness especially on lying down, prolong chest pain, sudden onset palpitation (awareness of racing heartbeats) giddiness and loss of consciousness. Once recognised, immediate consultation is mandatory for proper evaluation especially with electrocardiography (ECG), Echocardiography and Cardiac Biomarkers.
At one end we need to change our lifestyle for prevention from getting heart disease and on the other hand to modify our behaviour to fight covid-19. So healthy diet, hydration, daily moderate exercise and absolutely no to smoking are some measures that keep heart strong for any kind of diseases. Social distancing, face mask on being the vicinity of someone, cutting short the interaction time, avoiding gathering and frequent hand wash are some solid proven measures to minimise the risk of Covid-19.
The COVID-19 pandemic has introduced a major disruption to the delivery of routine health care across the world. In addition to what we have discussed, the pandemic has additional implications for the management of the patient with established heart disease. In particular, it provides challenges for the use and introduction of secondary prevention measures.
Recommendation for heart patients in Covid times:
- Routine medical follow up over the phone or via video online chat wherever possible. There are certain conditions where face-to-face visits are still required and you should not miss a visit without first consulting your doctor.
- Delaying treatment of serious heart condition due to corona fear is strictly not advisable. Any symptoms related to heart requires urgent consultation for better outcome so if patient feel new onset chest pain, breathing difficulty, severe fatigue and giddiness should seek immediate medical attention.
- Eat well, regularly and healthily: Include whole grains, fruits and vegetables in your diet as well as drink plenty of water.
- Exercise: Although we all have to keep a safe distance from each other now, this doesn’t mean that you can’t go out. Think of a route you can take where you will not have to be in close proximity to others and go for a walk every day.
- Use virtual method of socialising but avoid excessive negative messaging. Spend time in recreational activities like listening music, reading books or anything which you enjoy doing.
Finally It needs to be understand clearly that risks of heart attacks and stroke far outweigh the risks of contracting Covid-19 and time is truly of the essence when heart troubles hit. Hospitals are safe and if you need to visit, you should.
Dr Sunil Gouniyal | Senior Consultant – Cardiologist | NH MMI Narayana Superspeciality Hospital, Raipur