Dr Bikram Kesharee Mohanty, Sr Consultant Cardio – thoracic & vascular surgeon (adult & pediatric), visiting consultant to National Heart Institute, New Delhi shares that
sudden deaths due to heart attack is a known entity irrespective of pre or post-COVID period, though COVID is known to cause heart attack, however not as a late sequel in my practice. Dr Rakesh Rai Sapra, Director and Senior Consultant-Cardiology, Marengo QRG Hospital, Faridabad adds, “Sudden deaths due to heart attack is a known complication and were common even before COVID.
The celebrity deaths have surely brought more attention to it and also it has highlighted the fact that spurts of unaccustomed physical activity is dangerous. The physical activity for prevention of heart disease should be done on a regular (almost daily) basis and its intensity should be gradually increased as the body’s tolerance and stamina improves.”
Has COVID impacted the heart?
With the COVID tide receding, is there any visible extent of damage that we are seeing in general? Dr Vaibhav Mishra, Director – Cardiac Surgery, Max Super Speciality Hospital, Patparganj answers, “The real extent of damage is somewhat evident already.
It is something we don’t want to hear but post COVID we are definitely seeing a rise in cardiac cases mainly coronary artery disease leading to adverse cardiac events especially in the younger population. These effects are more pronounced in the younger population, and mostly seen in people who have had severe delta virus infections.”
Dr. Manish Bansal, Director, Clinical and Preventive Cardiology, Medanta, Gurugram adds, “
People who were acutely healthy were even presented with health conditions post COVID. Following COVID, many people with no prior history of heart disease showcase symptoms such as chest pain, palpitation, and breathing difficulty which are related to myocarditis and pericarditis. Furthermore, COVID involves blood vessels, causing inflammation in them and has a potential to form blood clots resulting in major heart problems such as a heart attack, stroke. So some of the heart attacks that we witness without any apparent reasons could be because of COVID.”
“While it is too early to comment about the exact cause, but as seen with severe delta COVID pneumonia which was associated with hypercoagulability of blood and dysfunction of lining of blood vessels leading to blockage of small arteries of lung, similar mechanism can be postulated for increase in coronary adverse effects,” adds Dr Mishra.
The common conditions that can occur after COVID are myocarditis, which causes inflammation in the heart muscle, and pericarditis causes inflammation of the outer layer, swelling and irritation of the thin, saclike tissue around the heart. Both these conditions were commonly seen in the patients post COVID and as a response to COVID vaccination as well. We have seen patients who have presented with symptoms of myocarditis or pericarditis. However patients should continue to receive vaccination because the benefits of vaccines outweigh the risks associated with this illness.”
Stress-linked heart ailments
Dr. Bansal explains, “
Heart attacks have recently become more prevalent. This has to do a lot with COVID as the disease resulted in job losses, hardships, financial difficulties, and other types of problems, all of which have caused increased stress in people, linked to an increase in the risk of heart attacks due to a blood pressure spike. It is difficult to say whether stress is directly causing more deaths or if COVID is to blame. However, heart attacks and some fatalities increased after COVID. However, people are becoming more aware of it as a result of the deaths of popular physically fit celebrities. In addition, people should begin to understand the importance of a healthy lifestyle and getting checked on a regular basis.”
Common heart issues seen post COVID
Dr Rakesh Rai Sapra explains the heart issues that have been seen post COVID:
a) Illnesses due to increased blood clotting tendencies like deep venous thrombosis, arterial thrombosis, heart attack and cerebral strokes.
b) Weakening of heart muscle due to inflammation of heart which is called myocarditis which leads to features of heart failure
c) Increased tendencies to abnormal heart rhythms called arrhythmias. This could be abnormal slowing of heart beat or abnormal type of fast heart beats. This could again be a new abnormality or exacerbation of pre existing abnormality.
Dr Mishra adds, “A very common finding in patients recovered from severe COVID is Tachycardia, which is abnormally high heart rate, more than 100 beats per minute. Such consistently high heart rate can damage the heart as the heart works harder than it should for days and months.
There is a still lot of be discovered about COVID, it is a relatively new and as time passes by we will have even more understanding about the disease and management, having said that based on current knowledge we do feel that a protracted course of blood thinners, Antiplatelets/Anticoagulants may accord benefit.
Any person having persistent high heart rate and unusual shortness of breath post COVID beyond 3-6 months should seek medical attention and not ignore this.”
Dr Dipu TS, Associate Professor, Division of Infectious Diseases, Amrita Hospital, Kochi advises people to avoid heavy exercises with limiting to slow walking in post COVID recovery phase or until 2-3 weeks after symptom resolution. Athletes are advised to avoid heavy cardiovascular training for up to 3 months post COVID and to be followed up with a specialist and to get the concurrence of the doctor if they want to return to training earlier. A little precaution always helps when we are in uncharted territory.
