Professor (Dr) Rajesh Vijayvergiya from the Department of Cardiology, Advanced Cardiac Center, PGIMER, said that all individuals with or without pre-existing cardiac disease have risk of developing cardiac disease due to Covid-19 infection. In patients with serious Covid-19 infection requiring in-door hospital admission, about 25 percent of them have some form of cardiac involvement. Severe cardiac injury leads to more need for oxygen supplementation, ventilation, prolonged hospitalization and death, he adds.
He says various factors like lockdown, fear of getting Covid-19 infection, suspension of OPD services, diversion of health resources to Covid-19 care etc. have decreased the reporting of various chronic diseases including heart diseases at PGIMER. Hence the number of emergency, OPD and indoor cardiac patients have decreased.
He says that infected heart patients should continue their medicines regularly without any interruption even during infection. They are supposed to consult the nearby Covid treatment facility where appropriate management can be chart out for the individual patient, he adds.
In an interview with The Pioneer, Professor Vijayvergiya talks on how the Covid infection causes side effects on the heart, lung and circulatory system and the importance of taking regular medicines for heart diseases. Excerpts from the interview:
As per reports, heart disease remains the leading cause of death during the corona period. Is there any link between Covid-19 and heart attack?
Covid-19 is predominantly a respiratory disease, but can have multiple organ involvement. Those with serious Covid-19 infection requiring in-door hospital admission, about 25 percent of them have some form of cardiac involvement. Severe cardiac injury leads to more need for oxygen supplementation, ventilation, prolonged hospitalization and death. The symptoms of heart attack are similar to non-Covid patients -- chest pain, jaw pain, uneasiness, fall in blood pressure, difficulty in breathing etc and one needs to immediately get ECG and certain cardiac markers to confirm the early diagnosis and emergency treatment. Covid-19 infection leads to clot formation, generalized inflammation, which leads to sudden clogging of heart arteries leading to heart attack.
Does Covid-19 carry an increased risk of complications in patients with heart disease?
Yes, comorbid illness such as heart disease, hypertension, diabetes, and heart failure are associated with Covid-19 related intensive care unit (ICU) admission, need for ventilation and increased death.
Has the number of patients with heart diseases at PGIMER increased during the corona pandemic?
Various factors like lockdown, fear of getting COVID infection, suspension of OPD services, diversion of health resources to COVID care etc. have decreased the reporting of various chronic diseases including heart diseases at PGIMER. Hence the number of emergency, OPD and indoor cardiac patients have decreased.
Has the heart attack death rate increased during Covid-19 pandemic?
There is no available data about increase or decrease heart attack related death during ongoing pandemic. Under-reporting of heart problems is one of the reasons.
As per reports, heart inflammation is one of the most common complications among post-Covid-19 among patients.
Various cardiac manifestations in Covid-19 disease include direct injury resulting in heart muscle inflammation, acute heart attack, irregular heart rate, heart failure, blood clot formation, low blood pressure and death. Individuals can have heart attack as the first presentation of the Covid-19 disease. Cardiac involvement is an independent marker of poor outcome during the illness.
Some people who have recovered from Covid-19 continue to have a heart rate of about 100 or so per minute.
Following the Covid-19 recovery, there are certain long term cardiac complications due to ongoing smouldering, chronic inflammation. These include heart failure, heart muscle scarring, heart attack, blood clot formation and irregular heart rate. A heart rate of more than 100-120 is frequent following Covid-19 recovery and is a marker of chronic inflammation. If symptomatic or troublesome, an increased baseline heart rate can be treated by certain drugs following the advice of the physician.
It has been anticipated that children will be hit worst in the third wave of the pandemic. What would you suggest for child patients with heart diseases?
Everyone including children with or without heart disease should follow the COVID appropriate behaviour and precautions as advised --social distancing, use of face mask and hand washing.
Who is more likely to develop cardiac issues? What are symptoms of heart trouble?
All individuals with or without pre-existing cardiac disease have a risk of developing cardiac disease due to Covid-19 infection. However people with pre-existing cardiac disease might have increased risk of worsening or decompensation of underlying cardiac disease.
Can people with underlying heart disease or those on blood thinners take the Covid-19 vaccine? What are the precautions for them during the ongoing covid-19 pandemic and after vaccination?
Yes, a person who has undergone any cardiac procedure (including cardiac stenting or open heart surgery) can get vaccination for COVID-19. Persons who are on blood thinners like aspirin, clopidogrel, ticagrelor can safely take Covid-19 vaccine. Persons on other types of blood thinners such as warfarin, dabigatran, rivaroxaban, apixaban and edoxaban, can also safely receive vaccination.