Post COVID – young hearts are under attack?

GUEST COLUMN: Dr. N Prabhudev

Three years into the Pandemic – Spike in Heart Attacks and Spike in heart attack deaths!

Bengaluru, March 13: New evidence has revealed that anyone infected with COVID is at higher risk for heart issues—including clots, inflammation, and arrhythmias—a risk that persists even in relatively healthy people long after the illness has passed. Long COVID seems to be associated with increased risk of death due to heart attacks.

It’s been three years since the World Health Organization declared COVID-19 a pandemic. So we know when the pandemic officially began. Is the COVID-19 over? COVID-19 has entered the “endemic” stage, indicating it will always be with us albeit seasonally- Thanks to a wall of immunity built from infections and vaccines.
Is COVID19 more like an irritating Flu? Not really! This virus is still very different from any other virus we have seen in our lifetime. The World Health Organization estimates that 2.9 lakh to 6. 5 lakh people die of flu-related causes every year worldwide.

The COVID-19 situation continues to change, sometimes rapidly. The mortality rate of COVID-19- is thought to be possibly 10 times or more than that of most strains of the flu.
Heart Problems after COVID-19
In India, the incidence of heart attacks and heart failure has increased by 25-30 per cent in people who got infected with COVID. India ranks highest in death from heart attacks. Indians have smaller calibre Coronary arteries and are prone to get blocked. Prior to the COVID-19 pandemic, heart attacks were the leading cause of death worldwide but were steadily on the decline.

Recently published in the Journal of Medical Virology—shows that Post COVID heart attack death rates took a sharp turn upwards for all age groups.
• The increase was most significant among individuals aged 25-44, who are not usually considered at high risk for heart attack.
• Adults between 45 and 64 saw a 19.6% relative increase in heart attack deaths, and
• Those 65 and older saw a 13.7% relative increase.
Heart Rate and COVID-19 – Palpitation – unrelated to exertion, for no apparent reason, points to post COVID sinus tachycardia. Shortness of breath, chest pain or palpitations after having COVID-19 are common complaints. Shortness of breath along with low O2 levels – below 90% is a concern. A cytokine storm and its resulting heart damage can affect the heart’s rhythm. Serious ventricular arrhythmias due to a cytokine storm can be catastrophic.

COVID19 is primarily a respiratory or lung disease but the heart suffers a great deal due to inflammation of the heart or Myocarditis. It increases the ability of arteries to clot and cause heart attacks leading to Hypoxic conditions – leading to cardiac arrest and eventual death.
Even seemingly fit people are dying of cardiac health issues while walking on the street, in the stadiums and on play fields, and even while just sitting at the desk.
• A type 1 heart attack, caused by a blood clot blocking the heart’s arteries, is rare after COVID-19 infection.
• Type 2 heart attacks are more common with COVID-19 caused by increased stress on the heart, such as a fast heartbeat, low blood oxygen levels or anaemia. Elevated troponin levels are a sign of damaged heart tissue. During acute COVID-19, elevated troponin levels with an abnormal EKG are linked to higher mortality.

Nature Medicine Journal – Post COVID patients are 72% more likely to get coronary artery disease. They were also 63% more likely to have a heart attack and 52% more likely to have a stroke, according to the study.

Patients who have already suffered COVID infection whether mild or severe must take aspirin tablets for at least one year Post COVID infection. The strict control of diabetes, high blood pressure, and cholesterol helps in preventing heart-related complications. Regular follow-ups with the physician and periodical blood tests like lipid profile, HBA1C, ECG, eco-cardiograph, and stress test are advisable. For a good heart, a healthy lifestyle and healthy food are the best medicines. Public education plays an important role!

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