While data on heart attacks following COVID is absent in India, cardiologists who have taken care of post-COVID cardiac issues in patients this past year suggest that people should avoid very severe exercise or unaccustomed extreme physical exertion for a period of three-four months after recovery from COVID. Moderation and continuing prescribed medication and contacting your doctor in case of an emergency are important, according to the doctors, who add that lifestyle changes protect persons against heart attacks in the long run.
“COVID is a new disease and we are still learning,” said G. Karthikeyan Professor of Cardiology, All India Institute of Medical Sciences, Delhi. He said that COVID did cause fewer admissions in hospital emergencies and discontinuing of medication also occurred among the patients.
“While there isn’t enough data to establish a direct link with post COVID and heart attacks, viral diseases are known to act as a trigger for heart attacks in pre-disposed persons,” said Dr. Karthikeyan. He added that continuing medicines, giving adequate time for recovery and consulting the doctor in case of emergency are vital safeguards.
Prof. (Dr.) Ashok Seth, Chairman Fortis Escorts Heart Institute and Chairman Fortis Healthcare Medical Council, explained that COVID causes heart problems irrespective of the severity of the COVID infection.
He said that Coronavirus causes inflammation in the arteries supplying blood to heart muscle along with an increase in blood clotting leading to sudden blocking of these arteries and heart attack. “Furthermore, inflammation and infection of heart muscle called myocarditis leads to weakening of heart pumping and heart failure. The virus can also affect the conduction system of the heart making the heart beat very fast or very slow, all these conditions can continue for many weeks after recovery from COVID and rarely can be life threatening,” he said.
Dr. Seth added that patients who have recovered from COVID, especially those who had severe COVID should not ignore any symptoms of breathlessness, chest pain or palpitations during the recovery period and should see their doctor at least once.
Stating that COVID infection does increase the blood clotting tendency which increases the risk of all diseases such as heart attack, stroke, deep vein thrombosis etc, Dr. Rakesh Rai Sapra, director and senior consultant of Cardiology, QRG Super Speciality Hospital Faridabad said that this risk is not life-long. “This risk is there primarily during COVID infection and for some period (1-2 months) after the infection. That is why blood thinners are given during that period to reduce the risk,” he added.
Speaking about an alleged recent spurt in young deaths due to heart attack, Dr. Sapra said that the increased predisposition of India for the development of heart disease is partly due to genetic predisposition and largely due to bad lifestyle which includes increased preference of junk food, sedentary lifestyle, increasing smoking habit and increasing mental stress.
The way out he suggests is aggressive modification of lifestyle including choosing the right type of food (increasing fruit and vegetables intake and reducing fatty food intake, especially the fried food and bakery products), doing regular (30-40 minutes daily) exercises, quitting smoking and learning to manage mental stress by yoga and meditation.
Meanwhile, explaining why COVID has no connection with young age and stating that it is mainly an inflammatory state, Dr. Ashish Agarwal, director-Dept. of Cardiology, Aakash Healthcare, Dwarka, said that COVID isn’t the reason for creating fresh blockages. “COVID makes the underlying blockages of the people unstable and it further leads to heart attack. COVID itself increases the blood flow in the body and that increases the chances of clot formation. So, if the clot is in an artery, it causes a heart attack. And, if the clot is in the artery of the lung then there is pulmonary embolism. That’s why most of the COVID patients have been given blood thinner injection on a regular basis,” he explained.
Stating that the purpose of vaccination is either to combat COVID infection or reduce the severity of the infection, Dr. Agarwal said that the most common reason for sudden death is cardiac arrest. “There could be many reasons behind it and the reasons also vary depending upon the age. Most common reason of cardiac arrest in the 35-40 age group is heart attack only. Heart attack in younger patients has always been there in India but the issue got hyped because of the death of few celebrities. We Indians have developed this coronary heart disease a decade earlier. It’s because of the genetic disposition, and immunity has got no connection with heart attack. Immunity is needed to combat infection,” he said.
Doctors also add that they are witnessing a fear in young patients about the sudden death due to heart attacks. “But, at the same time there is also an inertia of not taking medicines. Most of the young patients, who died, either they smoked heavily, had uncontrolled sugar, were hypertensive and had a family history of cardiac issues as well. We tell patients about their underlying conditions but they aren’t ready to take medicines. People feel until and unless they don’t have severe health conditions they won’t take. If you have a history of cardiac arrest, have a healthy lifestyle,” he said.
