TIRUCHY: Forty-year-old Ajit (name changed) tested positive for Covid in June end. He recovered slowly and was back to his regular routine in 20 days. However, after a month, he experienced severe chest pain and breathlessness. When he visited the hospital, he was diagnosed with a heart attack. Doctors say that they have been seeing several patients like Ajit, presenting with heart issues post Covid.
The risk of heart attack and stroke is increased three-eight fold in the first two weeks following Covid-19, according to a study published in The Lancet. The study compared the occurrence of heart attack, and stroke in 86,742 Covid-19 patients with 348,481 control individuals in Sweden in September 2020.
Dr Balasubramanian, HOD Cardiology, Mahatma Gandhi Memorial Government Hospital (MGMGH) said that they have been seeing several cases of heart disease in patients who have recovered from Covid.
“We are seeing patients with myocarditis, which is an inflammation of the heart muscle (myocardium). We also see heart attacks, which happen due to narrowing of the coronary arteries. Routine patients have a cholesterol block, however, in covid patients with heart disease, we sometimes don’t see a cholesterol block. Only inflammation can cause a thrombus in covid patients,” says Dr Balasubramanian.
Cardiologists say that Covid is a pro-thrombotic virus, which means that it tends to create blood clots.
“Covid is a virus that promotes blood clots. Some people may be living with a 30-40% block in their arteries, without being aware of it. After Covid, the block suddenly becomes bigger and causes a heart attack. Sometimes, Covid itself presents as a heart attack. We have seen 4-5 patients where heart attack was the presenting feature of Covid. This is a difficult situation as we cannot touch the clots when the patient has Covid, as it is a pro-inflammatory condition,” said Dr Karthick Anjaneyan, Senior Consultant- Interventional Cardiologist, Gleneagles Global Health City.
Doctors say that patients with diabetes, hypertension, family history of heart disease, smokers, must be extremely cautious if they get Covid. They advise regular heart check-ups for six months after recovery from Covid.
“Covid causes inflammation in the entire body, and blood clots. This can lead to heart attack, myocarditis, heart failure and pulmonary embolism. It can also cause a stroke. For patients with underlying coronary artery disease, COvid can aggravate and increase the disease. We have seen patients present with heart diseases from one month to three-four months after recovery. It causes silent heart attacks too. Low oxygen, which occurs during Covid, can aggravate heart problems,” says Dr Madan Mohan B, Senior Consultant, Interventional Cardiologist, MGM Healthcare.
Doctors say that few blood tests must be done by patients with Covid, even if they are in-home quarantine. These blood tests are Cardiac enzyme, C-reactive protein (CRP) and D-Dimer.
“If D-dimer is elevated, we give patients anti-coagulants for a few months. Pulmonary embolism, a blood clot in the lung, is very common in covid patients. I would also ask patients to get an ECG and Echocardiogram done for a few months after recovery, as it can pick up heart failure, along with the blood tests,” adds Dr Madan.
Doctors say that if any patient experiences chest pain or breathlessness after Covid, they must immediately go to a nearby hospital and get an ECG done.
“Patients must be very cautious. Don’t ignore chest pain thinking it must be acidity. Go to the hospital immediately, within an hour of the pain. Steroids given in the treatment of Covid can also cause heart issues. We prescribe clot breaking medicines as a precautionary measure for patients getting discharged,” adds Dr Karthick.
Doctor's advice