Change of heart

Doctors explain ‘spike in heart attacks amongst young adults’ post covid-19 and why pandemic may be to blame

Just as covid-19 pandemic led to health complications amongst individuals, there has even been a marginal rise in cases of heart attack amongst the youngsters — health professionals say they have seen an increase in heart attack cases amongst the youth who have had no health problems so far.

At the Jayadeva Institute of Cardiovascular Sciences and Research, doctors have seen over a 5% increase in heart attacks post covid-19. “We have seen a marginal increase in heart attacks amongst children and even adults. Even during pre pandemic times, we have had cases of youngsters with heart attacks. According to a study done at Jayadeva Hospital, over 30% of the youth are ending up with heart attacks. The reason for heart attacks post covid could be due to the formation of clots in the blood during infection and even after recovery. In most of the cases, youngsters suffer heart attacks due to use of narcotic drugs, family history of heart attacks or even smoking,” said Dr CN Manjunath, director, Jayadeva Hospital.

In one of the cases, a 24-year-old patient was under intense stress at work and personal life. He had chest pain for two days prior to presentation and had a febrile illness three weeks ago which had subsided spontaneously. The patient, however, ended up with a heart attack.

Dr Pradeep Kumar D, senior consultant, interventional cardiology, Aster CMI Hospital, said covid causes hypercoagulability of blood which results in blood clots within the arteries causing heart attacks in minimally diseased or normal coronary arteries.

“There’s a spike in heart attacks in young adults with no risk factors (including smoking) in the recent past, including that of a 24-year-old man the other day. I have treated at least 20 people with heart attacks under the age of thirty in the past few years. Following covid, many individuals who had no prior history of heart disease exhibit myocarditis and pericarditis-related symptoms such as chest pain, palpitations, and breathing difficulty. Covid or long covid may leave cardiac vessels permanently inflamed. When there are risk factors for heart disease, such as high blood pressure, diabetes, high cholesterol, smoking or obesity, this can rupture hidden blockage and result in a heart attack, especially after unusual workouts like heavy lifting, treadmill jogging, or running in cold weather.

Additionally, covid affects arteries, inflaming them, and has the potential to cause blood clots, which can lead to serious heart issues including a heart attack, or stroke. Therefore, covid may be to blame for some of the apparent causeless heart attacks. Although it is too soon to speculate on the precise causes, a similar process can be proposed for a rise in coronary negative impacts. As seen with severe delta covid pneumonia, which was linked to hypercoagulability of the blood and dysfunction of the lining of blood vessels likely to lead to blockage of small arteries of the lung,” he explained.

Dr Keshava R, senior director of interventional cardiology, Fortis Hospital said while the exact cause of youngsters ending up with heart attack post covid-19 pandemic phenomenon remains somewhat elusive. “It is believed to stem from the inflammatory response and resultant blood vessel damage caused by the virus. In order to safeguard against the onset of heart problems, it is crucial for young people to adopt a proactive approach toward health. This involves maintaining a balanced diet, engaging in regular physical activity, refraining from harmful habits such as smoking and excessive alcohol consumption, and effectively managing stress levels.

Additionally, monitoring and addressing any pre-existing medical conditions is also of utmost importance. It is equally critical to emphasise the importance of post-covid recovery care. This includes ongoing monitoring of one’s health, seeking medical attention for any concerning symptoms or changes, and following up with a healthcare provider for thorough assessment and management of any potential long-term effects of the virus,” he noted.

For those who are into fitness, health professionals pointed out the need of getting themselves checked or screened before starting off.

“We advise thorough vetting, especially for the high-risk population — diabetics, hypertensives, smokers, individuals with high cholesterol, people with a strong family history of cardiovascular disease, physically inactive and obese individuals — before they go to the gym, run a marathon, or engage in an abruptly unfamiliar high-intensity activity. A thorough clinical examination, an ECG, and potentially an echocardiography are all parts of the screening process. Additionally, the fitness programme must be under supervision,” said Dr Pradeep Kumar.