As the country battles a second wave of coronavirus, Dr Ashok Seth, chairman of Fortis Escorts Heart Institute, tells Rhythma Kaul what it means for people with cardiac issues, or individuals who run the risk of developing irreversible damage to their heart.

How serious is the Covid-19 situation in terms of cardiac involvement?

We are getting cases but fortunately, the same element of heart involvement is not there as of now as it was the last time around. It could also be because the people have largely been under home quarantine this time around, and come to hospital only when they feel sick. We will have to see in the coming weeks the exact pattern of after-effects in such patients who have recovered from Covid-19 as it takes that much of time for the effects to show.

What other reason do you suspect is leading to fewer patients showing cardiac involvement?

Covid-19 vaccinations have started and that, according to me, could perhaps be the reason why people may not be getting severe diseases. However, as I said, it would be too early to comment at this stage on the exact nature of involvement.

What are the heart conditions that people may get due to Covid-19?

Myocarditis is common, that is inflammation leading to weakening of the heart muscles, and affecting the heart’s pumping function. If the ejection fraction (the amount of blood the heart pumps out with each contraction) for anybody has dropped, it is worrying. The normal ejection fraction is about 60%. It is not that only severe cases would show cardiac involvement post Covid-19; we have seen damages even in asymptomatic patients. Blood clotting leads to heart attack and pulmonary embolism and stroke, especially in younger people. Besides this, the heart starts beating at a faster or irregular rate. However, these (effects) have not been seen at this stage.

What tests can be helpful?

All those who recovered from Covid-19 should get at least an Electrocardiogram or ECG and an echocardiogram (ECHO) done, especially ECHO, as some people have a weak heart. One ECHO four weeks after recovery and another three months after recovery is absolutely necessary to check on the health of the heart. There is another test for Covid-19 patients, Troponin, to detect any heart muscle damage.

What is the treatment protocol for cases of heart diseases?

An immediate angioplasty for patients suffering a heart attack with full PPE protection (is required) in Covid-19 cases. The treatment is to give medicines to those with weak heart muscles that will help in their function. However, these are not anti-viral medicines. We also advise against vigorous exercise and ensure sufficient rest for the heart to heal. At least 50% (of patients) could be left with residual damage, but there is an equal percentage that can potentially recover to some extent.

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