By Charity Wanja
Coronavirus (Covid-19) has been associated with multiple direct and indirect cardiovascular complications including acute myocardial injury, myocarditis, arrhythmias and venous thromboembolism.
Myocardial infarction or injury commonly known as heart attack occurs when blood flow decreases or stops to a part of the heart, causing damage to the heart muscle. While Arrhythmias is irregular heartbeat conditions in which the heartbeat is either too fast or too slow.It could indicate severe heart damage.
Myocarditis, also known as inflammatory cardiomyopathy, simply means inflammation condition of the heart muscle. On the other hand, Venous thromboembolism (VTE), refers to when blood clots in the deep veins usually in the leg, groin or arm then breaks loose and travels to the lungs blocking some or all of the blood supply.
Therefore, Covid-19 infection may have longer-term implication for overall cardiovascular (CVD) health. However, long-term follow-up data concerning the survivors of the virus are scarce.
Patients with heart disease and risk factors such as hypertension and diabetes are at high risk of severe Covid-19 disease and death. On the other hand, Covid -19 infection has been found to cause heart damage and even heart attacks in individuals who were previously healthy with no history of any heart disease.
Though there are less infections coming to hospital for admissions, Dr Bernard Samia a Cardiologist at MP-Shah Hospital affirmed. He has so far treated about 60 cardiovascular patients suffering from Covid-19.
Dr Samia points out that new onset heart disease symptoms, may persist long after the patient has tested negative. In children, the mechanisms of disease to heart may be similar as adults though a majority of the children gets only mild symptoms.
“There are multiple mechanisms of Covid-19 causing heart disease-rhythm disorder and palpitations, heart attack from blood clots formation in the arteries, heart failure from weakened heart muscles, sudden death from clot in the lungs and heart failure,” Dr Samia noted.
For patients with pre-existing heart disease cardiologists have had to adjust medicines to align with new blood pressure and sugars during infection.
“Newly diagnosed heart disease in Covid-19 infection has posed a challenge of how extensive to do tests because of fear of exposure of medical staff and use of drugs that may make the heart disease worse,” he said.
There are no clear figures on mortality rate of heart disease because of the heterogeneity of cardiac diseases and varying severity of symptoms, though the higher the age group the more likelihood of co-morbidities in heart disease hence more severe presentation.
There are various ways patients with heart disease can protect themselves against the virus. The most recommended being that they have to remain current with vaccinations, including the pneumococcal vaccine given the increased risk of secondary bacterial infection with Covid-19.
“General measures like physical distancing, wearing face masks, staying away from public gathering and specific measures like getting vaccinated against other viral diseases. Dr Samia said on preventive measures.
Similarly, taking heart disease medicines prescribed appropriately to prevent deterioration in body’s immunity. Exercises of such patients will vary with the type of heart disease but generally exercise is good for the heart and whole body,” he emphasized.
Dr Samia, is a member of the Kenya Cardiac Society (KCS) and has been working closely with the Ministry of Health to ensure all health professionals are equipped with the knowledge and skills to manage heart disease in the context of the covid-19 pandemic.
Though not all health facilities in Kenya are able to treat a Covid-19 patient with heart disease, the KCS has been conducting meetings and developing guidelines on how to handle such patients.
“We have been conducting virtual meetings targeting health professionals across the county to ensure they are able to manage these patients. In addition, together with other stakeholders, we supported the Ministry of Health to develop the Interim Guidance on Provision of Service for Non-communicable Diseases (NCDs) during the Covid-19 Pandemic document to guide health professionals as they provide health services to patient with NCDs such as heart disease and cancer.
We have also worked closely with MOH and Health professionals to ensure provision services for patients with heart disease continues in both the public and private health facilities while safeguarding both the health providers and patients, ” said Dr Samia as they prepare for the World Heart Day celebrations on 29th September 2020.
The doctor is advising those with heart conditions to note that they may be at increased risk of getting Covid-19 and more severe disease, hence they need to take extra precautions. They should also adhere to treatment instructions with regard to their respective diseases and continue follow at their units of care.