Patients with pre-existing heart disease are concerned and confused about the impact coronavirus, known as COVID-19 may have on them. Dr Harinder Singh Bedi – Director, CardioVascular Sciences at Ivy Hospital, Mohali – has a number of patients who were panicking because of the fear of the virus.
In conversation with www.famepunjabi.in about the unprecedented challenge, he said there is much about COVID-19 that we do not fully understand just yet. Here, he clears confusion about the potential impact of the virus.
Q. How can Coronavirus impact the heart?
A lot of my patients ask “I have heart disease. Am I more susceptible to contracting this coronavirus?” and “Does COVID-19 impact patients with heart disease differently than people without heart disease?”
The coronavirus can impact the heart in several ways. Viruses as such are known to attack the heart and can cause viral cardiomyopathies in which the pumping chambers of the heart get weak and may fail to pump effectively. The coronavirus (flu virus) per se has been widely used in rabbit models to study cardiomyopathy so it is certainly capable of damaging the pumping chambers of the heart. However, no such specific case has been reported so far with COVID-19 symptoms. However, the patients who have heart valve abnormalities are indeed more susceptible to heart failure if they were to become infected with coronavirus.
Q. Is it common for infected patients with heart disease to be hospitalized?
The presence of underlying diseases of the heart, lungs, or other major organs predisposes patients to more severe infection and symptoms, as well as increased risk of death. That does not mean people with heart disease are more likely to contract the coronavirus. It just means that those folks are more likely to have complications once they do get it.
Q. Is it safe to have heart valve surgery considering the spread of coronavirus?
In my clinic a patient asked, “You have scheduled my aortic valve replacement in two days. I am concerned about coronavirus infection during surgery and in the hospital. Should I wait to have my surgery? Is it safe?”
Let me tell you, there is absolutely no reason to postpone elective or scheduled surgery. At the same time, it is very important to note that patients should not proceed with surgery if they are experiencing any symptoms related to a potential infection. If you are scheduled for heart valve surgery, or in fact any major procedure, and become ill with a flu-like illness, you should reschedule your surgery if possible. Ideally, you should be fully recovered from any illness before having any elective surgery. Make sure your hospital is Covid ready – ask your doctor.
Q. Am I at a higher risk to contract COVID-19 if I already have had heart valve replacement surgery?
Again several patients question about the risks of being infected after heart valve replacement surgery with either a tissue valve or a mechanical valve. People who have already have had heart surgery and are otherwise healthy, they should have normal immune systems. So, they should be no more susceptible to complications from a viral infection.
Q. Are patients with Mitral Valve Repair Rings more likely to get infected with COVID-19?
We now perform more valve sparing repair procedures which entail using devices called rings. You are NOT at increased risk for viral infections. Yes – bacterial infections (a bacteria is different from a virus) could damage your repair, hence we do prescribe antibiotics for patients who have an artificial heart valve or ring if they have to undergo any procedure e.g. tooth surgery.
To sum up, a heart patient is not specifically prone to COVID-19 .
So, do not panic at all. Just take appropriate general precautions (avoid crowded places, avoid handshake. if you have a cough, do so into a disposable napkin, hand wash with soap and water frequently, use 70% alcohol based hand sanitisers if hand wash is not possible. In case of fever, sore throat or cough, immediately see a doctor.
The author is Director Cardiac Sciences at the Ivy Hospital Mohali . He was earlier at the St Vincent’s Hospital in Sydney and the Escorts Heart Institute New Delhi. He is a pioneer in heart surgery.
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