The COVID-19 pandemic has created a situation of uncertainty affecting the entire world. While millions of people in India have been affected by the virus, the improving recovery rate is an encouraging factor. However, the after-effects of this virus on patients continues to be a major challenge. It has been observed that most of the patients who are recovering from COVID-19 are developing some form of cardiovascular implications even with no pre-existing history of heart-related ailments. COVID-19 infection triggers inflammation in the body that may weaken the heart muscle, lead to abnormalities in heart rhythm, and even cause clotting in blood vessels. There are several other ways in which COVID can affect the heart. It can cause inflammation to the lungs which can put strain on the right ventricle to deliver blood to the lungs. This strain can impair the right ventricle, causing right-sided heart failure with fluid backing up into the liver and kidneys. In few cases, it can also cause swelling and fluid accumulation in the legs and abdomen.
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Implications of COVID-19 on the heart
It has been seen that the patients who have recovered from COVID-19 may be potential recipients of myocarditis which can cause long-term heart ailments. Myocarditis is an inflammation of the heart muscle (myocardium). Myocarditis can affect your heart muscle and your heart's electrical system, reducing your heart's ability to pump and causing rapid or abnormal heart rhythms (arrhythmias).
Following are the complications which can develop from myocarditis:
- Heart failure
- Arrhythmia (rapid or abnormal heart rhythms)
- Increased risk of heart attack or stroke
- Cerebrovascular disease (stroke or blocked arteries which affects the brain blood vessels)
- Multisystem inflammatory syndrome in children (heart, lungs, blood vessels, kidneys, digestive system, brain, skin or eyes — become severely inflamed)
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Warning Signs
COVID-19 poses a greater risk to people who have underlying conditions like Coronary artery disease, high blood pressure, diabetes, and heart strokes. The symptoms of heart diseases vary from one person to another depends even upon gender. However, there are basic symptoms that can determine when a person needs to see a doctor. These include:
- Shortness of breath
- Chest pain
- Chest tightness, chest pressure and chest discomfort (angina)
- Pain, weakness, numbness, weakness or coldness in legs or arms, the limbs if the blood vessels in those parts of the body are narrowed
- Pain in the neck, jaw, throat, upper abdomen or back
Risk Factors
Although the exact cause of the cardiovascular disease is still unknown, there are a few factors that increase the chances of heart disease post-recovery. These include:
Age: As a person grows older, there is a higher risk of heart ailments to get damaged and narrowed arteries that can weaken or thicken heart muscle
Gender: Men are at a greater risk of heart disease as compared to women
Family history- A family history of heart disease increases the risk of coronary artery disease, especially when a parent develops it at an early age
Diet and lifestyle: An unhealthy diet and physical inactivity can contribute to the development of heart disease
High blood pressure: An uncontrolled high blood pressure can damage the arteries and other blood vessels that can affect the blood flow
High cholesterol levels: This can increase the risk of plaque formation and atherosclerosis
Diabetes- It increases the risk of heart disease and affect or damage the blood vessels.
Obesity: Excess weight directly affects other heart disease risk factors
Stress: Hypertension and stress may damage the arteries and trigger other risk factors for heart disease
Although age factor, male gender family history and others are commonly considered risk factors. In COVID recovered patients, Diabetes, smoking, cholesterol imbalance, Cardiovascular disease, if coexisting, makes the patient more susceptible to develop “Heart Failure and attack”.
Prevention
- Avoid smoking and consumption of tobacco
- Exercise at least 30 minutes per day on a daily basis
- Maintain a healthy weight
- Follow a balanced and healthy diet
- Control other health conditions like high blood pressure, cholesterol and diabetes
- Reduce and manage stress
- Practising good hygiene
While the above preventive measures can help keep heart health within check, it is important, especially for heart patients to monitor their heart regularly. Depending on the underlying conditions of the patient, medical tests such as D-dimer or CRP may be recommended. D-dimer helps in breaking down the blood cloths for detecting small fragments of protein and this can also reduce the risk of sudden cardiac death. CRP monitors the severity of disease in chronic conditions and can be done with routine health checkups and screenings. CRP can also help manage the potential risk factors and prevent several heart conditions.
(Dr. Naveen Bhamri is the Director and HOD of Cardiac Sciences, Max Hospitals, Shalimar Bagh)
