‘Prevalence of youth suffering heart attacks goes up post-Covid’

The prevalence of young patients with heart attacks has increased post-Covid. Covid has been a risk factor as even if the person feels that he has recovered, he may not realise that the virus causes some changes in the endothelium that can cause heart attack and stroke. Endothelium means inner layer of our arteries. Normally, it doesn’t allow blood to clot but if dysfunction occurs, it allows the blood to clot, leading to heart attack and stroke.

The prevalence of young patients with heart attack during Covid era was 11.5 per cent out of 624 patients. We took people with less than 50 years of age. The same population that is below 50 years was studied post-Covid and the prevalence was 13 per cent out of just 443 patients. We conducted a research during and after Covid pandemic. Young patients are coming up with all the spectrum of acute coronary syndrome that is ST – elevation Myocardial infarction, it’s a heart attack which causes 100 per cent accluison of artery, then is NSTEMI- Non ST Elevation Myocardial infarction where there is a lack of blood flow to the subendocardium and cases of unstable angina (USA). Unstable angina is also a condition in which there is pain in the heart at rest or minimal exertion.

What are the reasons for the same? Why is it happening?

The most common cause for sudden cardiac death in young patient is due to acute coronary syndrome (heart attack). Though major risk factors for heart attack are presence of diabetes mellitus, hypertension, dyslipidemia, lack of physical activity, stress, smoking and family history of heart attacks, yet since the Covid pandemic, even history of Covid has become important risk factor for coronary artery disease. Presence of any of the above risk factors increases the risk of acute coronary syndrome. We may feel that we have recovered from the Covid but sometimes the virus causes endothelial dysfunction and which may lead to further complications.

Cases of an attack have been reported while doing exercise or while doing any strenuous activity. How to pre-empt it and why does it happen?

Yes, there have been cases that have been reported while doing exercise, strenuous activity because any sort of vigorous exercise or activities leads to “increase in adrenergic activity” which causes precipitation of heart attack by causing rupture of plaque (cholesterol deposit) in the coronary artery. Secondly, dehydration/hypovolemia also increase the risk of heart attack during strenuous physical/mental activity. It is advisable that patient should not undertake undue degree of physical activity which they use to perform before Covid pandemic and take adequate rest and hydration.

What are the early signs the youth must not ignore?

The early signs of sudden cardiac events often include chest pain, shortness of breath, palpitation, syncope — fainting or sudden loss of consciousness and pre syncope which means feeling that you are about to faint. Rather, most common cause of missed diagnosis of heart attack includes ignorance by the patient of the above symptoms. Most of the time patient considers and mistakes these symptoms as heart burn or gastritis which mimics the pain of heart attack because of right artery occlusion. All patients with new onset gastritis or increased feeling of gastritis should report to their doctor and they should get evaluation done.

Precautions one should take to prevent such strokes?

Precautions one should take include control of blood pressure, blood sugar, cholesterol and leading a healthy physical active lifestyle. Secondly, if a patient has a history of Covid in the past, they also are a part of newer risk factor for heart disease. If the patient has above risk factors, they should have regular consultation with their doctor and it is advisable to take low-dose aspirin along with statin and PPI / H2 receptor blocker as a preventive measure. Also, one should not over exert. Keep taking breaks within every half an hour or 40 minutes if one is continuously standing or doing any
activity.