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Wednesday, July 28, 2021

‘Multidisciplinary post-COVID clinics are the need of the hour’

Pressure on chest, chest constriction, pain in the chest, heaviness, simple gastritis symptoms, giddiness, profuse sweating, loss of consciousness, are some of the symptoms being reported post-Covid, and according to Dr RK Jaswal at the Fortis Hospital Mohali, these must be examined and not ignored, as 1 out of every 10 case can turn into a serious cardiac issue.

By: Express News Service | Chandigarh |
Updated: July 5, 2021 3:30:14 am
Covid-19, he adds, can cause blood clots, and this could cause further complications, including heart muscle inflammation.

After lungs, the heart is the most affected organ by Covid-19 and while we know much more about the virus than we did last year, we still don’t know everything, as there are many new issues that are evolving, said Dr RK Jaswal, Director, Cardiology and Cath Lab, Fortis Hospital Mohali, which has treated over 3,500 cardiac patients, many of whom had pre-existing heart conditions or required cardiac care post recovery from Covid.

“We are witnessing the direct and indirect effects of the infection and involvement of the brain, kidney, liver. Looking at the future, I think multidisciplinary post-Covid clinics are the need of the hour, as a large population of the country has been affected with Covid-19,” said Dr Jaswal, adding that nearly 50 per cent of patients admitted to Covid ICUs needed the advice of a cardiologist.

Pressure on chest, chest constriction, pain in the chest, heaviness, simple gastritis symptoms, giddiness, profuse sweating, loss of consciousness, are some of the symptoms being reported post-Covid, and according to Dr Jaswal, these must be examined and not ignored, as 1 out of every 10 case can turn into a serious cardiac issue.

Reflecting on some of the cases, Dr Jaswal recalled a 68-year-old patient who presented with heart rhythm instability after being diagnosed with Covid-19, and needed immediate treatment, a 46-year-old who was diagnosed with Covid-19 in May, and post-diagnosis, complained of chest heaviness and difficulty in breathing. His angiography revealed that he had ‘Critical Single Vessel Disease’, for which he underwent stenting.

“As the above case studies showcase, several patients diagnosed with Covid develop heart-related ailments (especially if they have a pre-existing cardiac condition). While the majority can be stabilised with medicines, many develop serious complications, which necessitate life-saving cardiac interventions — such as coronary angioplasty, stenting, temporary or permanent pacemaker implantation, and pericardial fluid aspiration. Therefore, it is imperative that Covid and post-Covid patients exercise caution to safeguard themselves from developing complications involving the heart. Chest pain, dyspnoea, palpitations, excessive sweating, vertigo, a sensation of dizziness, transient loss of consciousness, acute shortness of breath and coughing heavily at night, swelling on face, abdomen and feet, tenderness in calf muscles due to deep vein thrombosis, and severe shortness of breath due to pulmonary embolism are some of the warning signs that patients should be on the lookout for.”

Covid-19, he adds, can cause blood clots, and this could cause further complications, including heart muscle inflammation. “We must watch out for any symptoms post-Covid. Around 96 per cent may account to nothing, but some could lead to serious implications, for the after-tremors can be very serious, if we are not prepared,” says Dr. Jaswal, adding that the golden rule to avoid getting infected is to stay at home, maintain social distancing, wear a well-fitting mask and wash your hands frequently. “Take all your prescribed heart medications regularly. Also, keep a record of daily readings of blood pressure and blood sugar. And remember that it is also important to stay hydrated.”

Prof Rajesh Vijayvergiya, Department of Cardiology, PGI, says that patients with underlying heart disease are at increased risk of complications, such as intensive care unit admission, ventilator support, and in some cases also death, following Covid infection. “Also, certain markers of heart injury, which we usually look for minor or major heart attacks, maybe raised in Covid infected patients without heart attacks, hence we have to cautiously interpret the findings and manage them appropriately. Covid infection leads to two types of cardiac complications — one is acute, and the other is chronic when the patient has recovered from the infection. Hence, heart patients who have recovered from the infection should also be evaluated for any progression of underlying heart disease or a new manifestation, especially those elderly with associated comorbid illnesses, such as diabetes, hypertension, renal failure, and chronic respiratory diseases,” explains Prof. Vijayvergiya.

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