Ever since coronavirus disease (COVID-19) was declared a pandemic by World Health Organisation (WHO), it became clear that the disease behaved differently among different subsets of patients. Pre-existing Cardiovascular disease and hypertension along with diabetes and advanced age, have emerged as fairly strong associates of a poor outcome in patients with this disease.
There have been some recent reports of patients with Covid-19 infection presenting as an acute myocardial infarction. When they were subjected to coronary angiography, it was found to be normal. Even though the advent has been less in recent times, the danger is still there. In this scenario, it becomes important to understand the effect on the heart after a COVID infection.
Coronavirus infection can involve the heart in three different ways:
1. Direct or indirect immunological injury causing myocarditis.
2. Stress related acute coronary syndrome.
3. Electrolyte and avid base disturbance leading to arrhythmias including sudden cardiac death.
It must be remembered that the former two viz acute coronary syndromes and myocarditis can have a similar presentation with chest discomfort, ECG changes, and cardiac enzyme elevation. Hence it is imperative for patients with known coronary artery disease to be extremely diligent with drug compliance and control risk factors.
It is important to remember that no specific drug has been proven to have a definite therapeutic role in coronavirus infection. A few drugs have been mentioned like Azithromycin and Hydroxy-chloroquine but these can prolong QT interval on Ecg and predispose individuals to life threatening arrhythmias. Hence, none of these medicines should be used as self medication and should be consumed only when prescribed by a physician.
While the coronavirus pandemic is a cause of concern for the entire world but a patient with a known history of heart disease has to be even more careful. Nowhere is the adage “Prevention is better than cure” more applicable than in such patients.
So, it is strongly advised to all cardiac patients to follow basic preventive measures such as social distancing hand washing and proper use of upper respiratory protection to prevent contracting the disease and prevent any adverse outcome. Also, those who have recovered from a coronavirus infection need to take special care of their heart.