Post-recovery, many COVID-19 patients report breathlessness, rapid heartbeats or palpitations, says expert

“Post-COVID-19 infection, there is an increased tendency of clot-formation which can lead to heart attack and brain attack,” says Dr. Rakesh Rai Sapra, director cardiology, QRG Hospital, Faridabad.

October 03, 2021 03:12 pm | Updated 11:37 pm IST - NEW DELHI:

Representational Image.

Representational Image.

Pay attention to that “I am still feeling ill inside signal,” say doctors. It is your body asking you to be careful, warns Rakesh Rai Sapra, director cardiology, QRG Hospital, Faridabad, who explained that after recovering from COVID-19 many patients still did not experience full recovery and complained about feeling exhausted following little physical activity.

“If patients continue to experience shortness of breath, rapid heartbeats, or palpitations they should immediately consult their doctor,” he said.

“It's true that there has been a significant rise of patients post COVID-19 infection reporting breathlessness and rapid heartbeats or palpitations. Post-COVID-19 infection, there is an increased tendency of clot-formation which can lead to heart attack and brain attack [brain stroke]. Such patients are more prone to developing clots in their hands or legs which is primarily due to the illness. This tendency is not lifelong,” Dr. Sapra said.

The doctor added that the tendency to form clots was at its maximum during illness and a period of two months afterwards.

“Besides, for patients with other illnesses like diabetes or kidney-related ailments, we undertake a test called D-dimer and if the results are significantly higher (2 to 3 times the normal range), blood thinners are prescribed. Because the lungs get involved in the COVID patients there is a compromise of oxygen in their body and the recovery takes time. We recommend such patients not to increase their physical activity once they have recovered from the illness but gradually increase their physical activity. Enhanced physical activity will lead to compromise of oxygen in the body leading to emergency situations,” explained Dr. Sapra.

Cardiac deaths

He added that of late there had also been a spurt in sudden cardiac deaths among the youngsters and said that the primary reasons for this new trend affecting our productive age group were smoking, drug substance abuse, undue mental stress and unwanted physical activity.

“A sudden cardiac arrest happens after a heart attack when a clot disrupts the blood flow to the heart. The region where the heart does not receive blood supply starts behaving abnormally. The blood pressure drops down drastically and thus puts the person at risk of death. Smoking leads to the development of plaque in the artery. If the plaque ruptures, the cholesterol gets exposed and develops clots and this leads to heart attack,” he said.

The lungs are the organs most affected by COVID-19 and speaking about how the infection affects the inner surfaces of veins and arteries, Col. Vijay Dutta, senior consultant-Internal Medicine, Indian Spinal Injuries Centre, said that this process could cause blood vessel inflammation and hamper the functioning of the heart.

“Many people have developed cardiovascular diseases due to this and are going for a pacemaker implantation procedure. These complications have also led to swelling of heart muscles, leading to pump failure also. This is causing sudden death due to heart failure. In some cases, blood pressure is also getting dropped,’’ he said.

Doctors say that due to cardiac failures, the need for heart replacement or transplant has come up. In many cases, where the heart is not working due to respiratory failure or crippled lung or heart, they are requiring pacemakers. The heart of many people has become so dysfunctional that it is working only 15-20%; such people are facing breathlessness leading to medical therapy failure, even at a young age.

“So, they are only left with a cardiac transplant option in order to survive. This problem is coming in every age group as COVID doesn’t discriminate. COVID is affecting even newborns in the mother's womb or uterus and it remains with the newborns for a long time,” he added while stating that cardiac deaths in COVID-19 patients were not uncommon and that it accounted for about 10-15% of deaths in people suffering from moderate to severe symptoms.

Rajpal Singh, director-Interventional Cardiology & Heart Failure, Fortis Hospitals, Bangaluru, said that mechanisms leading to sudden cardiac attacks in patients were speculated to occur because of thrombosis in the heart resulting in heart attacks and therefore heart rhythm abnormalities.

It could also be because of inflammation of the heart muscle, known as myocarditis, or due to pulmonary embolism, thrombosis in the arteries cutting off supply to the lungs. Following this, the recommendation of blood thinners is mandatory in patients with significant COVID-19 illnesses and/or in recovery from the same.

“It was initially believed that COVID illness is self-limiting and so is the cardiac damage but according to a few studies, up to 70% of COVID patients MRI’s show long-term inflammation and scarring in the heart, predisposing people to sudden deaths either in the form of slower heart rhythms or faster heart rhythms (ventricular castellation). Therefore, it is advisable for COVID patients to see a cardiologist, have an echocardiogram, and get cardiac troponin and pro-BNP levels checked. A 24-hour call monitoring is also recommended. A holistic approach is needed for both acute as well as long-term cases,” Dr. Singh said.

He added that higher presence of conventional practices such as smoking, hypertension, diabetes etc, significantly increase the risks of sudden cardiac death and needed to be addressed in the same setting as well as the management as COVID-19 illness

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