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Post-Covid cardiac care is important. Pixabay

Heart specialists and cardiologists have sounded the alarm on the Covid-19 virus affecting the heart and its processes, causing many fatalities.

Ravindra Singh Rao, Specialist, Structural Heart Disease, Jaipur who is an expert in the Shock Wave Lithotripsy Angioplasty Technique, shares insights on heart problems commonly seen in Covid-19 patients, non-Covid cardiac care, and post-Covid recovery.

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Q: It is common to see heart problems amid Covid-positive patients, with young people getting affected as well. What have been your experiences with the virus affecting people’s hearts?

Sudden cardiac death can be due to a heart attack. Pixabay

A: Heart problems are seen in Covid-19 infection. It can vary from sudden cardiac death to minor problems in heart rate. Sudden cardiac death can be due to a heart attack. There can be clot formation in heart blood vessels. Clots can also be formed in lung blood vessels causing pulmonary embolism. Viruses can also affect heart muscles causing cardiomyopathy and heart failure. A common problem post-Covid-19 is variation in heart rate. Slow heart recovers in the majority of patients spontaneously in a few weeks. No active treatment is required. SARS-CoV-2 is the virus that causes Covid-19, and studies have shown that many viruses can cause arrhythmia and even heart attacks. Covid-19 causes a severe inflammatory response in the body, and inflammation is the biggest cause of heart attacks. Myocarditis, or inflammation of the heart muscle, usually only occurs in people who have a severe illness from Covid-19, and can be caused by the virus entering the heart. Recent studies have suggested that a milder form of heart muscle inflammation may be more common than previously thought.

Q: What is causing heart-related fatalities in such patients?

A: Heart-related patients are seen due to heart attacks (myocardial infarction). Covid creates a Millen for thrombus formation. Covid-19 patients who suffer a cardiac arrest either in or out of hospital are far more likely to die than patients who are not infected with the coronavirus. In particular, women have the highest risk of dying: they are nine times more likely to die after suffering a cardiac arrest in a hospital.

Covid infection is more likely in people with heart disease and high blood pressure. Pixabay

Q: Doctors have sounded an alarm on how changing lifestyles will increase the burden of heart disease in India. What are your thoughts on this, as a doctor?

A: Heart disease and high blood pressure (hypertension) put you at greater risk with Covid infection. Around 28.4 million elective surgeries worldwide were canceled or postponed in 2020, which is a huge healthcare burden and also makes the patients more vulnerable to bad outcomes. Coronary heart disease prevalence rates in India have been estimated over the past several decades and have ranged from 1.6 to 7.4 percent in rural populations and from 1 to 13.2 percent in urban populations. Physical inactivity, stress about health or future, and other factors are increasing the risk of heart diseases.

Patients must continue their medications. With confusing news about common blood pressure medications and their connection to Covid-19 risk, you may be tempted to stop taking them. But the pendulum is swinging toward there being no cause for concern. In fact, a New England Journal of Medicine study concluded there was no link between blood pressure meds and Covid-19 risk.

Patients must remember to take their medications as prescribed. Pixabay

If there is a non-essential medication or a good alternative ask your doctor, he may well change it, but if it is an essential medication it is suggested that it should be continued as there isn’t any concrete evidence to stop them at the moment.

Q: How can a recovered Covid patient take care of their heart at home? What are some care tips?

A: Post-Covid cardiac care is important. Cardiac patients should continue their medicines timely. Aerobic activity is encouraged. Blood thinners should be continued. Sometimes patients with elevated d-dimer need anti-coagulants for a few weeks as per consultation. What is important is 45 minutes of daily exercise, a balanced diet, and a positive mindset to keep their heart healthy.

Choose heart-healthy foods and snacks (plant-based and unprocessed foods are good choices). Maintain a normal body weight: Having obesity increases your chance of serious illness from Covid-19. Exercise daily. Stay hydrated by drinking plenty of water; Get enough sleep by aiming for seven to eight hours of shut-eye a night. Don’t smoke or overindulge with food or alcohol.

Stay hydrated by drinking plenty of water. Pixabay

Follow your care plan, stay up-to-date with vaccines and call if you have questions or concerns; use telehealth options if new symptoms or concerns arise. Ensure you have at least one month of prescribed medication at home. Finally, maintain social distancing, but don’t socially isolate yourself. Stay connected with family and friends.

Q: Five final tips for people who gained a few extra kilos in this altered lifestyle?

A: If you are on a keto diet and because of a limited supply of food material and also lack of domestic hired help, you are not able to do a keto it is fine and you can plan a low-carb diet. When things normalize you resume your earlier diet.

Intermittent fasting is a very good idea. You can skip either a breakfast or a dinner start within the duration of 12 hours gradually increasing to 18 hours of dieting for at least five days a week. Try not to snack in between the meals. Keep exercising and working out — dancing, rope skipping, yoga aerobics, and exercising. Use apps.

Try to avoid snacking in between meals. Pixabay

Calories are what matters the most, fewer calories, less weight. Make a menu on what you have ahead for a week so that you don’t end up in the stock situation and land up in a high calorific diet.

Q: What are your experiences with non-Covid cardiac care?

A: Non-Covid cardiac care can’t be put on hold. Cardiac emergencies don’t come with an appointment. We need to designate an area in the hospital that is segregated in terms of ventilation, patient movement, staff movement. The cardiac emergencies are handled and attended to on time. The advantage in the second wave is that all healthcare workers are vaccinated and ready to race the ‘enemy virus’. We have to focus on Covid-free cardiac care.

Cardiac emergencies don’t come with an appointment. Pixabay

Recently one patient in Kolhapur, his coronary artery had calcified blockages that were likely to cause the artery to rupture or block the stent back if normal stenting was done. But intravascular shock wave lithotripsy (IVL) technique not only broke their calcified blockages but also saved his lives with safe stenting. The patient felt breathless when walking a little. When the investigation at the local center revealed their calcified blockage, IVL was the effective option for its treatment. For this, when he reached Jaipur, providing him with Covid-free cardiac care was a big challenge. But better medical management enabled successful angioplasty of the patient. During the procedure, the OCT check fixed the stenting position inside the artery and fixed their blockage. This case is showing that patients should not hold their procedure in a pandemic.

ALSO READ: Hypertension Patients Need To Be Extra Careful Of Covid: Experts

Shock Wave Lithotripsy Angioplasty Technique has come now as an option to treat calcified blockage patients. It is now possible to insert stents through intervention by doing Angioplasty. This will be helpful for those patients who do not have the capacity to bear bypass surgery. Until now, it was difficult to perform stenting from interventions in arteries with calcified blockages as there is a 30-50 percent risk of re-closure or rupture of arteries after stenting. Shock wave lithotripsy is a sonographic technique. In this technique, calcium is broken through a sonographic wave and a stent is inserted. This causes no damage to the artery and fine particles of calcium become part of the artery. Angioplasty with this technique takes 45 minutes to an hour and the chances of recurrence of blockage remain about five to seven percent only. (IANS/KB)

(coronavirus, cardiac cycle, Heart disease, Shockwave intravascular lithotripsy, the human heart)


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Hugs, caress scenes, extramarital affairs, vulgar and bold dressing, bed scenes and intimacy of married couples are being glamourised in utter disregard to Islamic teachings and culture of Pakistani society," PEMRA stated

The Pakistan Electronic Media Regulatory Authority (PEMRA) has directed Pak TV channels to stop airing what it calls indecency and intimacy in dramas, Samaa TV reported.

A notification issued by the authority states that it has been receiving numerous complaints from viewers who believe that the content being depicted in dramas does not represent the "true picture of Pakistani society".

"PEMRA finally got something right: Intimacy and affection between married couples isn't 'true depiction of Pakistani society and must not be 'glamourized'. Our 'culture' is control, abuse, and violence, which we must jealously guard against the imposition of such alien values," said Reema Omer, Legal Advisor, South Asia, International Commission of Jurists.

"Hugs, caress scenes, extramarital affairs, vulgar and bold dressing, bed scenes and intimacy of married couples are being glamourized in utter disregard to Islamic teachings and culture of Pakistani society," PEMRA stated, as per the report.

The authority added that it has directed channels time and again to review content with "indecent dressing, controversial and objectionable plots, bed scenes and unnecessary detailing of events".

Most complaints received by the PEMRA Call Centre during September concern drama serial "Juda Huay Kuch is Tarah", which created quite a storm on social media for showing an unwitting married couple as foster siblings in a teaser for an upcoming episode. However, it only turned out to be a family scheme after the full episode aired, but by that time criticism had mounted on HUM TV for using the themes of incest to drive the plot, the report said. (IANS/JB)

Keywords: Pakistan, Islam, Serials, Dramas, Culture, Teachings.