How to care for your heart during COVID: for people with and without heart conditions

Whether you have an existing heart condition or not, it is more important than ever to consider your heart’s health. Dr Ahsan is an award-winning consultant cardiologist and in this article, he explains several aspects of caring for your heart during the COVID-19 pandemic.

Are patients with diagnosed/existing heart conditions more at risk of severe COVID symptoms?

Yes. The first thing to say is that patients with existing heart conditions aren’t more likely to contract COVID-19, but if they do contract the virus, they’re more likely to have a worse experience regarding the symptoms and risk of complications. This is why patients with existing heart conditions have been asked to be extra careful in terms of shielding and taking preventative measures.

How serious is the risk of severe symptoms?

From the data so far, we know that patients in high-risk groups have a higher risk of severe symptoms and death from the virus compared to the non-high-risk groups.

This applies to patients with a lot of existing heart conditions:

• Hypertension (high blood pressure)
• Coronary artery disease
• A stent
• Cardiomyopathy (heart muscle disease)

I’m frequently asked questions such as “I have high blood pressure, am I more at risk?” and to answer this, we have to look at how severe the blood pressure is. If a patient’s blood pressure has led to structural changes in the heart (this is called hypertrophy and is a thickening of the heart muscle), then yes, the patient is at risk. We must establish early which individuals are at a higher risk than others.

Should patients keep taking their medication?

Some medications should be stopped as they increase the risk of complications from the virus, but it’s incredibly important to base the decision on scientific fact. If a patient is concerned, they should have a detailed evaluation of their individual risk and seek a professional medical opinion before adjusting or stopping any medication.

Can COVID cause conditions like heart attacks or arrhythmias?

Yes. If we look at studies so far and cases of COVID patients who have been admitted to hospitals, we know that the virus increases the risk of myocarditis by attacking the heart muscle. This can lead to heart failure and arrhythmia (particularly ventricular arrhythmia). It can also increase the risk of heart damage and this is identified through biomarkers in the blood.

Heart damage from COVID can occur in a healthy person but the risk is higher in those with pre-existing conditions. Myocarditis will normally happen a few days after the patient has contracted COVID - it’s all part of the same inflammatory process that affects the rest of the body.

Current published studies show conflicting data. One study shows that 16% of all patients admitted to intensive care have developed an arrhythmia, but other studies show no significant increase.

How can people check their cardiovascular health?

We should all know what our blood pressure is. This is a simple thing that can be checked at home or at local GP practices. A lot of people will have undiagnosed high blood pressure, putting them unknowingly at risk of more severe COVID symptoms.

We should also know if our pulse is irregular. This is something that can be checked in a local pharmacy and GP practices. Furthermore, there are new devices which can quite reliability tell you if your pulse is irregular, meaning there’s no need to go to the hospital for a quick check.

Consider the following factors - these can greatly influence your heart health:

• If you have a history of cardiovascular conditions
• If you have a history of heart disease
• If you smoke
• If you live a sedentary lifestyle
• Your diet

The British Heart Foundation is a great source that has an abundance of information regarding how to keep your heart healthy.

Has the availability of check-ups and emergency help changed?

As it stands, we are trying to avoid patients coming into hospital if the visit isn’t absolutely necessary. This is to protect patients by limiting their potential exposure to COVID.

However, all hospital services are still running and if you’re concerned about your heart and overall health, there are still diagnostic tests available. We’re also doing online consultations. With this technology, we can do phone and video consultation appointments which can still be used to help patients address their concerns and even check their heart rhythm. We can send out ECG monitors in the post to patients.

And of course, if someone is worried about their health or has a heart attack or chest pain, absolutely call 999 emergency services because these services are running as normal.

Are heart procedures still going ahead?

All emergency heart procedures are being carried out as normal. Elective procedures were categorised into patients who needed urgent procedures and those who didn’t.

Generally, we are evaluating patients on a risk versus benefit case. Urgent procedures have been carried out and now we’re moving to start more routine and non-urgent procedures again (generally, ones where patients could wait up to a few months e.g. ablation procedures).

The key message to take away is that if a patient, or someone they know, is worried about their heart or cardiovascular health, they should seek medical attention and shouldn’t be afraid to do so. At all hospitals and clinics, we have very strict measures to prevent the spread of COVID.

To receive Dr Ahsan’s highly sought out medical care, visit his profile and arrange your online or face-to-face consultation.