ByIANSlife Features

September 20, 2020 (IANSlife) COVID 19 is a disease caused by novel coronavirus which has led to a global pandemic. As originally thought COVID-19 is not only a respiratory disorder, but it may affect several other body organs and may have other physiological manifestations as well. Symptoms may range from barely symptomatic to severe life-threatening complications. Heart damage has recently emerged as an important manifestation among other possible complications of COVID-19.

Dr Udgeath Dhir, Director and Head, CTVS, Fortis Memorial Research Institute, Gurugram explains this further. People infected with COVID 19 may develop a new heart-related problem or a complication of preexisting cardiac disease. Reports from the early days of the epidemic have described many instances of cardiac injury among patients hospitalised with COVID-19.

These patients had both elevated levels of cardiac troponin and abnormalities on electrocardiograms and echocardiography. Some reports have suggested clinical scenarios in which patients’ initial symptoms were cardiovascular rather than respiratory in nature. Heart failure has been one been one of the main causes of death in COVID 19 patients even in ones who do not have severe breathing problems. Damage to the heart tissue can be because of various factors.

People who have preexisting heart diseases are at a higher risk of severe cardiovascular and respiratory complications from COVID-19. Patients with COVID 19 have too many cytokines into the blood too quickly, known as a cytokine release syndrome, or cytokine storm which may lead to tachycardia, tachypnea and diaphoresis and elevated D-dimer. There may be fulminant inflammation of the heart muscle because of the virus directly infecting the heart. 

Second some people may experience direct damage to heart muscles something known as Myocarditis. The heart may also get damaged and inflamed indirectly by body’s own immune system response. Virus may cause stress Cardiomyopathy in which heart may lose its ability to pump blood. This further leads to irregular heart rate. 

Damage may mimic heart attack even in the absence of known previous coronary artery disease. Patients may suffer from chest pain / shortness of breath. This can occur when the heart muscle does not get enough oxygen, which in the case of COVID-19 may be triggered by a disparity between oxygen supply and oxygen demand. Fever and inflammation lead to accelerated heart rate and increases the metabolic demands on many organs, including the heart.

Thirdly, Covid 19 may render the blood more prone to clotting, while also interfering with the body’s ability to dissolve clots. COVID-19 has been found in numerous studies to cause hypercoagulability. Pulmonary embolism (PE) is seen in COVID-19 patients due to this clotting phenomenon. Acute pulmonary embolism is being recognized as a life-threatening manifestation of COVID-19.

Hence people with heart disease should stay in close touch with their doctors during this pandemic. They should also comply with their medications regularly to manage their heart condition. Patients experiencing chest pain or heaviness in chest to consult immediately as COVID 19 has been shown to cause damage to the heart mimicking these symptoms.

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