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Be alert, not anxious

The COVID-19 pandemic is on everyone’s mind right now. A majority of those infected recover from the disease. Twenty per cent of the patients may require hospitalisation, especially when there are complaints of breathlessness.

If they have coexisting conditions like chronic renal disease, cardiac disease, respiratory disease, cerebrovascular diseases, uncontrolled diabetes or hypertension, they carry a higher risk of mortality. Mortality in COVID-19 positive cases ranges from 2% to 8% worldwide.

When we talk about COVID-19 infections and heart diseases, we face four scenarios — patients with known cardiac disease; cardiac patients developing COVID-19 infection; patients with COVID-19 infection developing cardiac complications and patients waiting for or have already had cardiac transplant

For cardiac patients: The most important thing to remember is to continue taking your medication if you have a known cardiac condition. You must also take the following precautions: Avoid physically visiting the hospital for your routine check-ups. Utilise their online consultation facility, if available, to speak to your doctor. Stay at home to prevent contact with carriers. Practise social distancing in case you have to interact with others.

Consciously avoid touching your face. If it’s absolutely necessary, wash your hands with soap and water for at least 20 seconds or use a hand sanitiser containing at least 70% alcohol.

Work on optimising your immune system. Getting adequate sleep, staying hydrated, eating a balanced diet and exercising every day are paramount.

Keep in touch with friends, colleagues, family and others remotely. Your mental health can affect your physical health, so don’t neglect that!

Remember this: Even if you don’t catch the infection, stressing about the situation can worsen your heart condition. So, it’s important to be alert and not anxious.

For cardiac patients who develop an infection: Maybe you’ve come to the hospital with chest pain. You may not have COVID-19 but the hospital may have to test you for it. This is for everyone’s safety. If you test positive, you and anyone you have come in recent contact with you should be quarantined for two weeks.

There’s some evidence that shows a fever may actually be beneficial to your immune system in fighting the infection. So, for mild infections, fever can be treated with antipyretics. Antibiotics may be prescribed to you to treat secondary bacterial infections, if the symptoms are worse. Remember to consult your physician and do not self-medicate!

If you develop breathlessness or other serious respiratory symptoms, you may be admitted to the ICU. Any kind of infection may worsen cardiac failure or cardiac disease as it can produce inflammatory reactions that include vascular and myocardial inflammation.

COVID-19 positive patients who develop cardiac complications are conservatively managed. For example, a patient with Triple Vessel Disease who is a candidate for coronary bypass surgery may instead be managed by angioplasty or medically managed with plaque stabilising drugs such as statins and antiplatelet agents.

What about end-stage heart failure patients? End-stage heart failure patients are medically managed at present as the pandemic is making the logistics of transplantation difficult.

Patients who have already had heart transplantation are at a much higher risk for infection as they are on immunosuppressive drugs.

Our strategy is to prevent the infection among such patients by advising them to stay at home, use personal protective devices and maintain physical distancing. It’s normal to get worried about the pandemic given all the free time you have now and the exposure to several myths and misinformation. But worrying is not good for your health. Let the healthcare workers do their job and you focus on following the necessary precautions. Remember — stay alert, not anxious.

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