- COVID patients should not stop their existing medications: Dr Upendra Kaul
- People with comorbidities are more prone to COVID complications: Dr Kaul
- Occurrence of heart disease because of COVID is rare: Dr Praveen Chandra
New Delhi: In order to completely recover from COVID-19, it’s important to focus on post-COVID care as well. Off late, health experts have warned of complications in post COVID recovery phase that can lead to a cardiac arrest and in extreme cases a heart attack as well. Dr Upendra Kaul, Cardiologist at Batra Heart Centre recently had two COVID-19 patients who seemed to be on the way to recovery but later showed classic symptoms of a heart attack. Explaining the link between COVID-19 and heart attack, Dr Kaul said, “COVID-19 is an inflammatory disease. It produces inflammation in the body in most of the blood vessels. We also know that blood becomes thicker and often clot formation occurs in the lungs and heart arteries. If any patient recovering from COVID gets any new symptom again like shortness of breath which is out of proportion along with some peculiar sensation like a very fast or slow heart rate, unconsciousness, dizziness, one should always consider that it could be a heart attack. Especially in those patients who have underlying diabetes, high blood pressure and these people are much more vulnerable so they have to be much more careful.”
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NDTV spoke to experts to understand more about the long lasting symptoms of COVID-19 even after testing negative, the impact of COVID-19 on the heart, the symptoms to watch out for and the precautions to follow.
What Causes Heart Problem In COVID-19 Patients?
First and foremost, each person has different levels of COVID infection. There are mild, moderate, and severe cases and complications may differ from person to person. If we look at the heart issue specifically, the science tells us that heart damage can be due to high levels of inflammation circulating in your body. As the body’s immune system fights of the virus, the inflammatory process can damage some healthy tissues including those in the heart. COVID-19 infection also affects the inner surface of the veins and arteries which can cause blood vessel inflammation, small damage to vessels and some might lead to blood clots as well. All of which can compromise the blood flow of the heart or other parts of the body.
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The other thing is, some of the patients who already have had a heart problem, they are on some drugs which prevent the recurrence of heart attack. For some reason, they stop it. Stopping medications can lead to a problem which is why we always advise to please continue all your previous medicines of high blood pressure, cholesterol, diabetes, and consult your doctor, added Dr Kaul.
Dr Skand Trivedi, Head of Cardiology at Bansal Hospital in Bhopal believes other than the heart attack which is causing death is pulmonary embolism – a condition in which one or more arteries in the lungs become blocked by a blood clot. He said, it is quite common and added,
When patients are discharged from hospital, they continue to experience some breathing difficulty on walking one or two blocks. They start getting used to it but what has happened is that they have already got some pulmonary embolism and that continues to progress over a period of time and then one day it suddenly it just blocks everything and it throttles the patient literally.
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Who Is More Likely To Develop Cardiac Issues?
Dr Praveen Chandra, Cardiologist at Medanta Hospital in Gurugram said the very important thing is that the occurrence of heart disease because of COVID-19 is very rare. It is not common so common people should not start rushing to a cardiologist. Adding to this, Dr Deepak Davidson, Cardiologist at Caritas Hospital in Kerala added that the elderly subset of people and those with comorbidities like people who are diabetic, hypertensive, and people with lung disease are likely to have more complications during COVID infection.
These are the subset of people who are likely to develop cardiac issues and we also know from the data that the mortality in this subset of people is high. When somebody who has got heart failure and when he develops COVID-19 infection, mortality is going to be extremely high, added Dr Davidson.
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Experts Explain Post COVID Care: Dos And Don’ts
Dr Trivedi is of the opinion that the first three months after COVID-19 are crucial and one should take all kinds of precautions during that period. Patients should not stop their medication and any ailment that is suggestive of cardiac ailment like chest discomfort, sweating, sudden onset of breathless should be reported to the doctor immediately.
Further talking about the stress in post-COVID situation, Dr Trivedi said that most of the patients are under severe anxiety which according to him is taking its toll in the form of a heart attack. He further added,
There are additional factors; summers have already started and many patients who have recovered from COVID actually do not get well hydrated. They are very anxious and some of them have actually left cardiac medications.
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Dr Trivedi informed majority of the people who have recovered from COVID-19 continue to have a heart rate of about 100 to 120 per minute. So before panicking and thinking of it as a heart ailment, one needs to rule out a couple of things. He explained,
Firstly, we have to exclude that whether a person already has some degree of pulmonary embolism which is there or is it the part of myocarditis – inflammation of the heart. It will take three to six months for the myocarditis to settle and that will present with just tachycardia or palpitations. So, what I suggest is that for those of our patients, who are having tachycardia, it’s not a bad idea to get themselves screened by their physicians or cardiologists so that at least we are clear that the patient does not have baseline pulmonary embolism. The second reason for tachycardia is that many of the patients are hypoxic because of residual lung damage so that is another factor that is causing palpitation or increase in the heart rate. So those patients who are getting discharged from the COVID centre, especially if you are over 30, it is not a bad idea to visit a cardiologist or physician and they can advise.
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Dr Chandra reiterated to not panic and follow the advice of the doctor. He also urged people with underlying heart disease or those on blood thinners to take the COVID-19 vaccine without any hesitation.
Heart rate can go up because of low oxygen levels as well. Generally, it is temporary and it will settle down and most of the hospitals have heart specialists and physicians who can take care of it, he added.
Additionally, Dr Chandra suggested against exercising right after recovering from COVID-19 and testing negative. Especially those patients who had lung pneumonia or where the number CT count was 9 or 10.
Inflammation will take a few weeks to settle down. Do not try to over-exert. This will lead to excessive breathlessness or symptoms without any disease happening. Secondly, continue taking your medicines. Thirdly, eat well, drink well and relax. After 15-20 days of COVID one can even go back to the family, he added.
In conclusion, not everyone is prone to a heart attack. In fact, a heart attack can be caused by increased stress as well on the heart, low blood oxygen levels and other reasons including dehydration. A heart condition could be exacerbated by severe COVID-19 but not likely after mild or moderate COVID. But the effects of COVID-19 on pre-existing heart disease are not yet really known. Everyone recovering from COVID-19 should be careful and not panic.
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NDTV – Dettol Banega Swasth India campaign is an extension of the five-year-old Banega Swachh India initiative helmed by Campaign Ambassador Amitabh Bachchan. It aims to spread awareness about critical health issues facing the country. In wake of the current COVID-19 pandemic, the need for WASH (Water, Sanitation and Hygiene) is reaffirmed as handwashing is one of the ways to prevent Coronavirus infection and other diseases. The campaign highlights the importance of nutrition and healthcare for women and children to prevent maternal and child mortality, fight malnutrition, stunting, wasting, anaemia and disease prevention through vaccines. Importance of programmes like Public Distribution System (PDS), Mid-day Meal Scheme, POSHAN Abhiyan and the role of Aganwadis and ASHA workers are also covered. Only a Swachh or clean India where toilets are used and open defecation free (ODF) status achieved as part of the Swachh Bharat Abhiyan launched by Prime Minister Narendra Modi in 2014, can eradicate diseases like diahorrea and become a Swasth or healthy India. The campaign will continue to cover issues like air pollution, waste management, plastic ban, manual scavenging and sanitation workers and menstrual hygiene.