COVID-19 pandemic and heart disease

The COVID-19 pandemic is changing our lives in unprecedented ways. Given the lack of safe and effective vaccines or proven treatments for COVID-19, our main strategy in the fight against the pandemic is to adhere to the basic prevention formula of social distancing, wear face masks, avoid crowds and wash their hands repeatedly with soap. The capacity of health systems globally has been strained (and in some countries completely overwhelmed), and the effect of this pandemic on social interactions, health care delivery and the global economy continues. to intensify.

Although the predominant clinical manifestation of COVID-19 is viral pneumonia, clinical studies have also reported an association between COVID-19 and cardiovascular disease. COVID-19 can also cause cardiovascular disorders such as myocardial damage, arrhythmias, acute coronary syndrome and thromboembolic complications. Some patients who present without the typical symptoms of fever or cough have cardiac symptoms as the first clinical manifestation of COVID-19.

Myocardial damage during COVID-19 is independently associated with high mortality. Potential drug-disease interactions affecting patients with COVID-19 and comorbid cardiovascular disease are also becoming a serious concern. Cardiovascular comorbidities such as hypertension and coronary heart disease are associated with high mortality in patients with COVID-19. Finally, drugs that have been proposed as treatments for COVID-19 (although there is no absolute cure available yet) such as hydroxychloroquine and azithromycin have pro-arrhythmic effects – atrial fibrillation; ventricular fibrillation; Ventricular tachycardia.

While the number of patients admitted to hospital emergency rooms for an acute heart attack has decreased, there is a marked increase in deaths from cardiac arrest at home. This can probably be due to the postponement and delay in seeking medical care. Therefore, it is important to emphasize that heart patients should not ignore any symptoms and/or delay medical care, as this will further deteriorate their health. According to research, the risk of dying from a heart attack is much higher than that of dying from COVID-19. Additionally, cardiac death is largely preventable if heart attack patients present themselves to the hospital in time to receive treatment. Even if a heart attack doesn’t kill a patient immediately, experts say delaying treatment could have life-changing consequences, including heart conditions like cardiomyopathy and congestive heart failure. That’s why quick action is needed.

Worse still, shelter-in-place orders can cause people to fall into unhealthy routines, which could increase the risk of heart attack. These include eating poorly, exercising less, or relying more on substances such as alcohol, smoking, and drug addiction. Not being able to see our friends and loved ones, including disruptions to our routine, can be bad for our hearts. Research has shown that the inflammation caused by depression can increase the risk of heart attack.

When to Seek Emergency Care for COVID-19 and Heart Problems

The US Centers for Disease Control and Prevention (CDC) says to watch out for:

â–ª Dry cough.

â–ª Fever or chills.

â–ª Shortness of breath or difficulty breathing.

â–ª Muscle pain.

â–ª Loss of taste or smell.

– Gastrointestinal symptoms such as nausea, vomiting or diarrhoea.

Risk factors

You may be born with certain risk factors that cannot be changed. The more of these risk factors you have, the more likely you are to develop coronary heart disease.

The increase in age

The majority of people who die of coronary heart disease are 65 or older. While heart attacks can strike people of either sex in old age, women are at a greater risk of dying (within weeks).

male gender

Men have a greater risk of heart attack than women, and men have heart attacks earlier in life.

Heredity (including race)

Children of cardiac parents are more likely to develop heart disease themselves. Most people with a strong family history of heart disease have one or more other risk factors. Just as you can’t control your age, gender, and race, you can’t control your family history. It is therefore even more important to treat and control any other modifiable risk factors you have.

Modifiable risk factors

Tobacco / smoking

The risk of smokers developing coronary heart disease is much higher than that of non-smokers. Smoking is a strong independent risk factor for sudden cardiac death in patients with coronary artery disease. Smoking also interacts with other risk factors to significantly increase the risk of coronary heart disease. Exposure to second-hand smoke increases the risk of heart disease even for non-smokers.

High blood cholesterol

As your blood cholesterol levels rise, your risk of coronary heart disease also increases. When other risk factors (such as high blood pressure and tobacco smoke) are also present, this risk increases even more.

High blood pressure

High blood pressure increases the workload of the heart, causing the heart muscle to thicken and stiffen. It also increases your risk of stroke, heart attack, kidney failure, and congestive heart failure. When high blood pressure is added to obesity, smoking, high cholesterol or diabetes, the risk of heart attack or stroke increases even more.

Physical inactivity

An inactive lifestyle is a risk factor for coronary heart disease. Regular moderate to vigorous physical activity helps reduce the risk of cardiovascular disease. Physical activity can help control blood cholesterol, diabetes and obesity. It may also help lower blood pressure in some people.


People who have excess body fat are more likely to develop heart disease and stroke, even if those same people have no other risk factors. Overweight and obese adults with cardiovascular disease risk factors such as high blood pressure, high cholesterol, or high blood sugar can make lifestyle changes to lose weight and significantly manage other modifiable risk factors .

Diabetes seriously increases your risk of developing cardiovascular disease. The risks are even greater if blood sugar levels are not well controlled. If you have diabetes, be sure to work with your doctor to manage it and control any other risk factors you can. To help manage blood sugar, people with diabetes who are obese or overweight should make lifestyle changes, such as eating better or exercising regularly.

Individual stress response may be a contributing factor to heart attacks. Some scientists have noted a relationship between the risk of coronary heart disease and stress in a person’s life, as well as their health behaviors and socioeconomic status. These factors can affect established risk factors. For example, people under stress may overeat, start smoking, or smoke more than they otherwise would.

Drinking too much alcohol can raise blood pressure and increase the risk of cardiomyopathy, stroke, cancer and other diseases. It can also contribute to high triglyceride levels and produce irregular heartbeats. In addition, excessive alcohol consumption contributes to obesity, alcoholism, suicide and accidents. That said, there is a protective benefit to avoiding alcohol consumption altogether.

Diet and Nutrition

A healthy diet is one of the best weapons you have to fight cardiovascular disease. Choose nutrient-dense foods, which contain vitamins, minerals, fiber and other nutrients, but contain fewer calories than nutrient-poor foods. Choose a diet that emphasizes vegetables, fruits and whole grains. A heart-healthy diet also includes low-fat dairy products, poultry, fish, legumes, nuts, and non-tropical vegetable oils. Be sure to limit your intake of sweets, sugary drinks and red meats. To maintain a healthy weight, coordinate your diet with your level of physical activity so that you use as many calories as you take in.

If you think you’re having a heart attack or other heart problem, don’t take it home because you’re worried about COVID. It’s really important to come and be assessed so you can fix the problem quickly. There are many helpful ways to help prevent a heart attack. These include controlling your blood pressure, maintaining a healthy weight, eating a healthy diet, exercising regularly, monitoring your cholesterol and triglyceride levels and keeping them under control. Also, control your social life choices, such as limiting your alcohol intake and avoiding smoking cigarettes. Vaccine development is expected to take several months. To address the urgent need for effective treatments and preventive strategies, a concerted effort must be made by researchers around the world to study and integrate biological and clinical findings related to COVID-19.

(The author works at Narayana Hospital, Jammu)

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