Even as COVID-19 rages on, prevention is key for stroke and heart patients. While it is normal for people with heart conditions to feel anxious about how this disease might affect them, they are not at a higher risk of developing COVID-19 than any other healthy individuals. However, if people with heart conditions do get infected with the virus, they have a greater chance of developing medical complications.
Groups that are known to be at higher risk of developing severe complications due to COVID-19 include:
- People aged 60 or above. Those over 70 are most vulnerable .
- People with long-term medical conditions like diabetes, high blood pressure, stroke (or previous stroke), heart disease, kidney disease, lung disease, liver disease or cancer.
- People with a weak immune system (immunosuppressed).
- People with medical conditions that affect their breathing.
COVID-19 and the Heart – the Connection
COVID-19 was initially thought to be only a respiratory disease, affecting the lungs. And, when the lungs were not able to work at full steam, the strain on the heart increased as it had to work harder to pump pure (oxygen-rich) blood all around the body. This added stress was thought to be risky for people with heart conditions.
While the entire focus of the COVID-19 has been on respiratory problems and securing enough ventilators, it is now also observed that COVID-19 patients are developing heart problems and losing their life due to cardiac arrest. As more data is coming in, cardiac specialists have started believing that COVID-19 virus can infect the heart muscle. An initial research study found cardiac damage in approximately 1 in 5 COVID-19 patients, leading to heart failure and death even in those who show no signs of respiratory distress.
COVID-19 Risk in People with Heart Disease
As people with heart disease are at greater risk of severe illness if they contract COVID-19, they are generally advised to stay at home and limit their social contact as much as possible. While all people with underlying cardiovascular disease are at a greater risk of medical complications if affected by COVID-19, those at an even higher risk include people who:
- Had a heart transplant (more recently or at any time in the past)
- Had recent open-heart surgery including valve repair or replacement and CABG (Coronary Artery Bypass Grafts)
- Are pregnant with a heart conditions
- Heart disease with other conditions like chronic lung disease and kidney disease
- Heart failure
- Heart valve disease
- Congenital heart disease
- Cardiomyopathy
- Angina
Frequently Asked Questions
I have a heart condition. Am I at more risk of getting COVID-19 infection compared to those with no heart condition?
No – anybody can contract COVID-19. But, people with underlying heart conditions are at greater risk for severe infection than others.
What precautions can I take to avoid contracting COVID-19?
Keep up with the New Normal
The first thing you should do is to continue with what you are already doing. This includes staying at home whenever possible, wearing a mask and practising safe distancing when outdoors, sanitizing as much as possible and seeking medical attention immediately if you are having problems.
Cultivate and Keep Up with a Healthy Lifestyle
Don’t forget the basics. Stay healthy by:
- Exercise Regularly as per advice of yoru treating doctor
- Get enough rest
- Eat a healthy diet
- Discuss with your treating doctor on adding nutrition supplement and immunosuppressant to your daily regime
- Keep track of your blood pressure (if you have hypertension)
- Do not miss your regular medication
Should I keep taking all my medications?
Yes! Do not stop any of your prescribed medications. Stopping your medicines without having a discussion with your treating doctor can be a fatal mistake. This advice is also for those taking drugs like ARBs (angiotensin receptor blockers) and ACE inhibitors (angiotensin converting enzyme) generally used to treat both heart failure and high blood pressure.
When to Seek Emergency Care for COVID-19 ?
Get to know the signs of a COVID-19 infection. Watch out for the following symptoms:
- Fever or chills
- Dry cough
- Trouble breathing or shortness of breath
- Loss of taste or smell
- Muscle pain
- Gastrointestinal symptoms like diarrhea, nausea, or vomiting
When to Seek Emergency Care for Heart Problems?
However, heart and stroke symptoms are also trouble — and may signal COVID-19 infection as well. Therefore, watch out for:
- Facial drooping on one side
- Chest pain or pressure, particularly during physical activity
- Arm numbness or weakness on one side of the body
- Speech changes, like slurred or garbled speech
- Severe headache
- Loss of vision
- Breathlessness or shortness of breath at night associated with:
- Dizziness
- Leg swelling
- Fainting
- Passing out
What do I need to know about the COVID-19 if I have a heart valve problem?
Due to your condition, you are at greater risks of complications from COVID-19, which makes caution extremely important. Do everything possible to avoid exposure to COVID-19 infection. Staying home and away from other people is critically important — especially if you are aged 60 and above. Stay focused on the safety basics: hand washing, not touching surfaces and cleaning surfaces thoroughly. And, remember to take your medicines as prescribed, stay in contact with your treating doctor, and be sure to eat well and stay physically active. If you are preparing for a procedure, be sure and get plenty of rest.
What if I am advised regular INR checks at the clinic?
Your regular INR checks depends on the advice of your physician. If you take warfarin (blood thinner), regular monitoring of your INR level is vital. But at the same time, your healthcare team would also like to reduce your risk for COVID-19. So, before making any changes, discuss the same with your doctor.
If you’re INR levels are stable, your doctor may advise reduction in the frequency of your testing. In such case, you should continue to monitor your food intake carefully and become additionally aware of foods that may impact INR levels. On the contrary, if your INR level is unstable and may need frequent dose adjustments, look out for home-care diagnostic testing services, if possible, in your location. But, your healthcare provider will be in the best position to advise you on this.
Am I at greater risk of getting COVID-19 infection, if I have atrial fibrillation?
Atrial fibrillation by itself does not increase the risk of COVID-19 infection. However, many atrial fibrillation patients are older and have other conditions like hypertension, diabetes and heart failure, which make them more vulnerable for more severe disease, if infected. Therefore, you are advised to take general protective measures like social distancing and sanitizing regularly and appropriately to prevent infection.
I have read that COVID-19 can cause heart problems like heart attack or arrhythmias, is this true?
Based on the inflammatory effects of the virus that causes COVID-19, there are hypothetical risks that the viral infection may cause rupture of atherosclerotic plaques (fatty deposits) in the coronary arteries, which may lead to acute coronary syndromes (heart attack). People who experience severe chest discomfort during symptoms of COVID-19 should immediately call their healthcare provider or the treating doctor.
Severe systemic inflammatory conditions can aggravate arrhythmias or may even trigger atrial fibrillation in some people. The acute inflammation caused by the COVID-19 infection can worsen both cardiac as well as kidney function
However, you should strictly follow the recommendations to prevent becoming infected such as frequent hand washing, personal distancing, or even better, self-isolation.
What if one of my loved ones or I am experiencing the signs of a heart attack, or stroke or a cardiac arrest?
Don’t delay getting care for any of your heart issues. If you or your loved ones have warning signs of a heart attack or stroke, call your healthcare provider immediately or treating doctor. You can call Apollo Emergency Helpline 1066 too. Our emergency systems ensure that all patients who have cardiac emergencies not related to COVID-19 get the care they need with no risk of being exposed to the infection.
I am a heart patient; I think I have COVID-19. What should I do?
Isolate yourself immediately and contact your treating doctor and get the necessary medical intervention immediately without delaying care. You may also contact Apollo Hospitals helpline: 1860-500-1066 for assistance.
What is the role of Anticoagulation in COVID 19?
COVID-19 can be complicated with coagulation disorders with a high incidence of thromboembolism and disseminated intravascular coagulation. D-dimer might help in the early recognition of these high-risk patients and also predict the outcome. There are current recommendations suggesting that all hospitalized COVID-19 patients should receive thromboprophylaxis, or full therapeutic-intensity anticoagulation if such an indication is present.
Conclusion
It is also important for heart patients to look after their emotional health and well-being as anyunexpected changes to daily lives can be stressful, and the COVID-19 situation is no different. In addition, with focus on reducing contact outside the home, it is also important to maintain a healthy lifestyle habit and not to disregard the normal exercise routine that your doctor has advised. As exercise may not be possible outdoors in the current scenario, look out for online options to exercise indoors. Check with your doctor always before making any changes to your fitness regime.
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