‘Covid-19 may spark heart trouble in myriad ways’
The coronavirus (COVID-19) was first reported in Wuhan, China, in late December 2019. Since then, it has spread rapidly worldwide and has become a global pandemic, affecting 200 countries and territories, with devastating effect on public health.
Heart damage has recently emerged as yet another grim outcome in the virus’s repertoire of possible complications.
There have been reports where some patients, who presented without the typical symptoms of fever or cough, have cardiac symptoms as the first clinical manifestation of COVID-19.
Although the predominant clinical manifestation of COVID-19 is viral pneumonia, COVID-19 can also cause cardiovascular disorders such as myocardial injury leading to heart failure, arrhythmias, heart attack and thromboembolism.
Coronavirus-induced acute myocardial injury, as evidenced by elevated levels of cardiac troponin—a protein released in the blood by the injured heart muscle—and abnormalities on electrocardiograms and heart ultrasounds is observed in 7–20% of patients.
Furthermore, a possible link between COVID-19 and a Kawasaki disease-like syndrome has been described in children. Potential drug–disease interactions affecting patients with COVID-19 and co-morbid cardiovascular diseases are also becoming a serious concern.
Covid-19 may spark heart trouble in myriad ways.
The first explanation is that pre-existing heart conditions, such as damaged heart muscle or blocked heart arteries, weaken the body’s ability to survive the stress of the illness. A person with a vulnerable heart is more likely to succumb to the effects of fever, low oxygen levels, unstable blood pressures, and blood clotting disorders — all possible consequences of COVID-19 — than someone previously healthy.
A second explanation relates to poor underlying metabolic health, which is more common in those with heart disease.
Poor metabolic health refers to diseases such as type-2 diabetes or pre-diabetes and obesity, which themselves cause inflammation and risk of blood clots, compounding the effects of COVID-19 and increasing the likelihood of devastating complications of COVID-19.
Finally, there is a subset of people with COVID-19—some of them previously healthy and with no underlying cardiac problems—who develop fulminant inflammation of the heart muscle as a result of the virus directly infecting the heart.
This type of inflammation could lead to heart rhythm disturbances and cardiac muscle damage as well as interfere with the heart’s ability to pump blood optimally.
This can be life threatening, and it can happen in people who don’t have any preexisting risk factors.
If you have heart disease, it’s particularly important to take special care to stay healthy and avoid getting infected with COVID-19.
Advice for readers is:
1) Wear masks and maintain social distancing.
2) Don’t delay in getting care for heart issues - For some heart problems, every minute counts.
3) Take your heart medication on time as advised.
4) Do not take unproven drugs to treat Covid-19 Azithromycin, Hydroxychloroquine have shown to have cardiac side effects.
5) Get vaccinated
THIS TYPE OF INFLAMMATION COULD LEAD TO HEART RHYTHM DISTURBANCES AND CARDIAC MUSCLE DAMAGE AS WELL AS INTERFERE WITH THE HEART’S ABILITY TO PUMP BLOOD OPTIMALLY. THIS CAN BE LIFE THREATENING.
Writer is senior interventional cardiologist at United Medicity –Medical College and Hospital, Director, Asha Heart Care and & Research Centre, Prayagraj.