With altered lifestyles for fear of contracting COVID-19, cardiologists are worried because exercise and diet has taken a backseat, and anxiety and fear looms — none of which bode well for the heart
Even though 17 lakh people have died of cardio vascular diseases this year in India (against one lakh COVID deaths), the scare over COVID is obvious given its highly contagious nature, says Prof Ambuj Roy, professor of cardiology, at AIIMS, Delhi. “Acute (immediate) care always wins over chronic (long-term) care,” he says. “With COVID inducing a kind of unhealthy and fear-ridden lifestyle, it calls for greater caution because in the long run, heart health can be impacted in many ways. We should not neglect what is not apparent.”
What is apparent is this. Cardiologists across the world are reporting a marked increase in sudden cardiac deaths even as the current focus has shifted to the challenges from COVID and other communicable diseases. “The complications of the virus for the human body may not have been still fathomed but COVID has a puzzling relationship with the heart too,” says Dr Amit Bhushan Sharma of Paras Hospital, Gurugram.
COVID has exacerbated existing heart problems. Independent studies from Italy, France, USA and China have corroborated a 50% decline in admission of patients with heart ailments due to their or their family’s reluctance to go to a hospital during the pandemic. A case in point is that of Inderjit, a bank accountant in Indore, with a low heart pumping capacity. With his meticulous regime of exercise, diet and medicines, he was stable since 2012. But he missed his routine follow-ups during the lockdown, scared of a hospital visit. During his walks, he began getting breathless recently and finally sought an appointment with his cardiologist after almost seven months. Tests revealed his heart was struggling to pump blood to the rest of the body, because his regular schedule was disrupted during the period he could not step out of the house. He is one of the several thousands of patients whose chronic heart condition turned acute during lockdown. .Inderjit’s medication was adjusted and his life saved, but many are not so lucky.
COVID could be one of the causes of heart problems. Researchers from the European Society of Cardiology has found teens who struggle with anxiety and depression could be at a 20% increased risk of heart attack when they reach middle age. With increasing reports of depression among our youths, one needs to be vigilant and look for signs that are beyond the normal teenage angst, says Dr..S Venkatesh, Consultant at Bengaluru’s Aster RV Hospital. “It is a must for those with a pre-existing heart problem or a recently diagnosed one to go for periodic screenings,” he adds.
Heart disease is setting in earlier than before. The Registrar General of India states 32% of adult Indians died between 2010 and 2013 due to cardio vascular disease, and that heart disease-related deaths are getting younger in India. A 2015 study in The Lancet found that 40% of Indians under the age of 55 develop heart attack. “Now 35-40 years is the new watch age in India; it is 15 years younger than in the West,” says Dr Sharma. Whether you are in your 30s or 50s, warning signs should not be ignored. Since co-morbidity is a concern with COVID, it is important to keep in touch with your doctors regularly, he adds.
Positivity can keep you healthy “It is important for cardiac patients to take control of their lifestyle habits and motivate behavioural changes as a positive move,” says Dr. Rahul Patil, interventional cardiologist, Sri Jayadeva Institute of Cardiovascular Sciences and Research, Bengaluru. According to a research published in the European Journal of Cardiovascular Nursing, heart attack patients who are sarcastic or irritable could be putting their health at risk. The study suggests hostility is an independent predictor of dying from a second heart attack after adjusting for other factors such as diabetes, high blood pressure, physical inactivity, stress, lack of sleep, smoking and unhealthy diet. “Stress resilience is strengthened with the release of serotonins (happy hormones). Remember you are never too young to lead a heart healthy lifestyle,” he says.
A new survey
With Indian cardiologists also witnessing fewer admissions and low attendance, the Cardiological Society of India initiated a national survey for the first time involving 200 hospitals across the country. Data of 41,000 heart attack patients who were admitted between March and June (the strictest lockdown months) has been collected and the findings are currently under analysis. The yet-to-be-published study, according to Dr Jabir Abdullakutty, a core committee member from Kochi, is going to be one of the most detailed scientific insight into what happened in heart attack admissions in India and its outcome during lockdown and early unlocking. “The cardiac and non-cardiac variables will explain the risk statistics and help to calculate the relative contribution of each factor to the high mortality rate,” he says.
The warning signs
Chest pain: Do not ignore the persistent pressure in the chest and dismiss it as gastric pain.
Difficulty in breathing: Differentiate between lung-related and heart-related shortness of breath. The former will occur due to an activity; the latter due to posture like when you lie down — there will be suffocation and choking.
Physical signs: Swelling of legs, bluish lips or face, disorientation, or talking gibberish
And the difference is?
Heart attack is a plumbing problem. There is damage to part of the heart muscle caused by inadequate blood flow to that area. Most of the time, this happens due to a blockage in one of the heart’s arteries and you feel heaviness due to sudden stoppage of blood supply. Needs immediate attention with clot busters or angioplasty to save life and from permanent damage
Cardiac arrest is an electrical problem. It happens when the heart’s electrical system malfunctions, causing it to beat rapidly and chaotically — or to stop beating altogether. A heart attack is a common cause of cardiac arrest, but most heart attacks do not lead to cardiac arrest.
Heart failure Is an underlying problem due to weakness or stiffness of heart muscles. It happens because of a previous episode of heart attack leading to progressive damage to the heart. It commonly presents with breathlessness and fatigue.
September 29 is observed as World Heart Day and this year’s theme is Use your heart to beat CVD