Since the beginning, medical experts have recognized that older adults with underlying heart issues are at higher risk of complications such as a heart attack if they are infected with COVID-19.

As the coronavirus keeps evolving every day, it can be especially worrisome if you or a loved one is living with a heart condition. As a longtime practicing cardiologist in Bangalore, I will try to answer each of these questions with the information we have gathered so far.

How do I know whether breathlessness is cardiac or due to coronavirus infection?

One of the symptoms of COVID-19 infection includes dyspnea, which is the sensation of shortness of breath or difficulty in breathing.

Shortness of breath can also be a serious cardiac symptom. Heart failure may cause breathlessness due to the inability of the heart in pumping blood efficiently. This leads to fluid build-up inside the lungs, which makes breathing more difficult.

So how can you tell the difference? There are equipment and tests that can help sort it out quickly if you’re in the emergency room but it can be difficult to interpret the symptoms if you are at home.

Firstly, it is important to determine if you have had close contacts with any individual confirmed or suspected of COVID-19, or if you have traveled to any area with a high infection rate.

Next, record your temperature to check if you are experiencing a fever. It really helps to have a thermometer at home as it is an essential medical kit at this time of the pandemic.

Also look out for symptoms such as dry cough, fatigue, sore throat, loss of taste or smell which are not related to heart diseases. These symptoms are more common with COVID-19 since it is a disease of the respiratory system.

These self-assessment methods can be used to help determine if you need to consult a health practitioner for a detailed evaluation.

Can I continue the existing blood pressure medications during this pandemic?

Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are among the most commonly administered medications to effectively normalize blood pressure and produce an excellent antihypertensive response in patients.

There was a concern at the early stages of the pandemic that these medications may affect the severity of coronavirus infections since the use of ACEIs or ARBs in rodent studies has shown to upregulate ACE2 expression.

This prompted an international team of researchers led by Perelman School of Medicine at the University of Pennsylvania to investigate if the use of ACEIs or ARBs could help mitigate complications or lead to more severe symptoms.

152 participants who were already hospitalized with COVID-19 and already using one of the medications were enlisted in the Replace Covid trial.

The participants from several countries were randomly assigned to either stop or continue taking their prescribed medication.

They were closely monitored to evaluate the effect of temporarily stopping the therapy, during the test held between March 31 and August 20, 2020.

The first randomized controlled trial concluded that the medication for the high blood pressure may improve COVID-19 survival rates, and reduce the severity of novel coronavirus infection, particularly in patients with hypertension.

Can any prescribed medications for coronavirus infection have cardiac side effects?

It has been over a year since the first case of coronavirus was detected but medical experts are yet to come up with a specific drug that can be claimed to be a proven treatment.

Currently, only off-label drugs that have been approved for other conditions are being used to treat COVID-19. We take a look at three drugs that have received the most public attention to know more about their side effects.

Favipiravir was the first repurposed antiviral drug, approved for the oral treatment of mild or moderate COVID-19 infections. Mumbai-based Glenmark Pharmaceuticals has been given permission to manufacture and market Favipiravir in tablet form under the name of FabiFlu. According to Glenmark, Favipiravir is safe to be administered to patients with heart disease in the recommended doses.

Remdesivir is an anti-viral drug patented by Gilead Sciences. It is an injectable drug for the treatment of moderate to severe COVID-19 patients. The drug is still being studied so all of its risks are not yet known at this time. Our real-world experience showed the beneficial effects of this drug in moderate to severe cases of Covid 19 pneumonia.

Hydroxychloroquine which is approved as a treatment as prophylactic in mild cases has side effects that can cause severe heart arrhythmia. Since multiple large clinical trials did not show benefits in treatment, the USFDA revoked its Emergency Use Authorisation. India moved the drug out of treatment protocol for severe cases.

Since most drugs are still undergoing clinical trials and only approved for emergency use, as a cardiologist who cares for your safety, I will strongly advise you against self-medicating or any treatment without a doctor’s prescription.

Is it safe to go to the hospital?

With Covid 19 cases reducing in number, it is of no major concern to worry about going to hospitals. Most of the hospitals are taking necessary precautions to screen, test, and isolate suspected cases in triage areas.

However, you are advised to visit your doctor when necessary and not to delay treatment due to the fear of infection. Prolonging an issue may aggravate the condition.

First and foremost, remember to take safety precautions and follow guidelines issued by governing bodies and medical authorities.

Guidelines such as wearing a mask and maintaining social distance should be always maintained when at the hospital.

What can I do to protect myself from the virus?

There are some simple precautionary measures that you can take to reduce your risk of contracting coronavirus. Make wearing a mask part of normal life when around other people.

Continue to maintain a physical distance of 2 meters to minimize the possibility of transmission.

Practice good hygiene by washing your hands regularly. Scrub your hands for at least 20 seconds and then rinse them well under clean, running water.

Ensure your mouth and nose are covered when you cough or sneeze. It is advisable to cough or sneeze into a tissue or your elbow rather than into your hands.

As the virus is prone to spread through the air, it is recommended to keep your rooms well ventilated by opening windows to allow the flow of fresh air in.

What are the recommendations for a heart patient?

If you have an existing heart condition, it is advisable to take all the necessary preventive measures to keep yourself safe and lower your risk of contracting the virus.

Make sure you stay extra vigilant by following all the basic preventive measures such as wearing a mask and maintaining social distance.

As a heart specialist, I would advise patients with cardiovascular diseases to keep up with the usual treatment and continue to take their prescription medications.

If you develop possible COVID-19 symptoms such as a cough and fever and think you might have coronavirus, speak to a medical practitioner to discuss the next steps.

With the vaccine around the corner, we are sure the pandemic won’t last forever. At the same time, we need your heart to last as long as it can, so do not forget to exercise and maintain a good diet. If you’re looking for a heart doctor in Bangalore, we are here for you.