COVID-19: Take Care of Your Heart!

Dr Udgeath Dhir, director and head, Cardiothoracic and Vascular Surgeons, Fortis Memorial Research Institute, Gurugram, explains why you must take extra care of your heart.

It was initially believed that COVID is only a respiratory disorder. But recent studies and findings have indicated that it may affect several other body organs and may have other physiological manifestations as well.

Symptoms may range from barely symptomatic to severe life-threatening complications in some cases.

Among these, heart damage has recently emerged as an important manifestation among other possible complications of COVID-19.

People infected with COVID 19 may develop a new heart-related problem or a complication of preexisting cardiac disease.

Reports from the early days of the epidemic have described many instances of cardiac injury among patients hospitalised with COVID-19.

These patients had both elevated levels of cardiac troponin and abnormalities on electrocardiograms and echocardiography.

Some reports have suggested clinical scenarios in which patients’ initial symptoms were cardiovascular rather than respiratory in nature. Heart failure has been one been one of the main causes of death in COVID 19 patients even in ones who do not have severe breathing problems.

Damage to the heart tissue can be because of various factors.

Here are three reasons why patients with heart condition should be careful about COVID:

People who have pre-existing heart diseases are at a higher risk of severe cardiovascular and respiratory complications from COVID-19.

1. Patients with COVID 19 have too many cytokines into the blood too quickly, known as a cytokine release syndrome, or cytokine storm which may lead to tachycardia, tachypnea and diaphoresis and elevated D-dimer.

There may be fulminant inflammation of the heart muscle because of the virus directly infecting the heart.

2. Some people may experience direct damage to heart muscles something known as myocarditis.

The heart may also get damaged and inflamed indirectly by body’s own immune system response.

The virus may cause stress cardiomyopathy in which heart may lose its ability to pump blood. This further leads to irregular heart rate.

The damage may mimic heart attack even in the absence of known previous coronary artery disease.

Patients may suffer from chest pain / shortness of breath. This can occur when the heart muscle does not get enough oxygen, which in the case of COVID-19 may be triggered by a disparity between oxygen supply and oxygen demand.

Fever and inflammation leads to accelerated heart rate and increases the metabolic demands on many organs, including the heart.

3. Covid 19 may render the blood more prone to clotting, while also interfering with the body's ability to dissolve clots.

COVID-19 has been found in numerous studies to cause hypercoagulability (increased tendency for the blood to clot).

Pulmonary embolism is seen in COVID-19 patients due to this clotting phenomenon. Acute pulmonary embolism is being recognised as a life-threatening manifestation of COVID-19.

Hence. people with heart disease should stay in close touch with their doctors during this pandemic.

They should also comply with their medications regularly to manage their heart condition.

Patients experiencing chest pain or heaviness in chest to consult immediately as COVID 19 has been shown to cause damage to the heart mimicking these symptoms.

Whether you have a pre-existing heart condition or not, it is important to have a wholeseome, nutritious diet with vitamins, nitrates, amino acids and antioxidants that will help improve the functioning of your heart.

Set aside at least 30 minutes of your day to do some form of physical activity.

Sleep well and on time. Avoid physical and mental stress to keep your heart healthy.