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Heart attack in young people: Why severe Covid patients should avoid too much exercise and work; expert take


Heart attack cases are rising in the country, especially in younger age group that also includes adolescents. Recently ten people succumbed to heart attack during Garba events in Gujarat and the victims includes teenagers as well as middle aged people. Citing an Indian Council of Medical Research (ICMR) research, Union Health Minister Mansukh Mandaviya has recently said that people who suffered from severe Covid-19 should not overwork or do strenuous exercises for a year or two. Covid-19 is said to weaken heart and lungs and overexertion can put a strain on these crucial organs. Covid can also increase blood clot risk. According to a study, the risk of heart attack was higher among people who had severe Covid-19 than those who did not suffer from it. Health experts told us that severe Covid survivors should avoid lifting heavy objects, climbing stairs, running, playing sports like football, basketball etc. (Also read: Dos and don’ts to take care of your heart during Garba celebrations)

Covid-19 is said to weaken heart and lungs and overexertion can put a strain on these crucial organs. (Freepik)

Why severe Covid patients should avoid over work and overexercise

Severe Covid-19 patients should avoid overwork and overexercise for a number of reasons. The virus can weaken the heart and lungs. Covid-19 can damage the heart muscle and lungs, making it difficult for the body to deliver oxygen to the tissues.

“Overexerting yourself can put a strain on your heart and lungs and make it harder for them to recover. The virus can also cause fatigue and muscle weakness. Covid-19 can cause fatigue and muscle weakness, which can make it difficult to exercise. Overexerting yourself can make these symptoms worse and delay your recovery. Covid can increase the risk of blood clots. Covid-19 can increase the risk of blood clots, which can travel to the lungs and cause a pulmonary embolism. Overexerting yourself can increase the risk of blood clots forming. The virus can increase the risk of long Covid,” says Dr Pawan Kumar Goyal – Senior Consultant- Internal Medicine, Fortis Hospital Shalimar Bagh.

“Covid patients who have Covid-induced pneumonia or Covid-induced blockages in the blood vessels of the lungs may have damage to the lungs. If one has survived Covid, that means they have survived the incident, but this Covid infection also leads to fibrosis of the heart, and fibrosis can also affect the lungs, causing stickiness in the lungs. This, in turn, affects the exchange of oxygen and carbon dioxide in the lungs, which means the normal functions of the lungs are affected. So, if the lung is already damaged and a person engages in heavy exercise, they may experience severe breathlessness. The situation of oxygen in the body goes down because of heavy exercise in the presence of lung damage due to Covid. Therefore, if your lung or heart is affected, you should avoid heavy exercise,” says Dr. Bipin Dubey, HOD and Consultant Cardiac Science, HCMCT Manipal Hospital, Dwarka.

Long Covid is a condition where people experience symptoms of Covid-19 for weeks or even months after they have recovered from the initial infection.

“Overexerting yourself during recovery can increase the risk of developing long covid. It is important to listen to your body and rest when you need to. Avoid strenuous activity until you have fully recovered from Covid-19. Talk to your doctor about when it is safe to start exercising again,” adds Dr Goyal.

Dr. V. Vinoth Kumar, Senior Consultant Interventional Cardiologist, CARE Hospitals, HITEC City, Hyderabad shares reasons why severe Covid patients should avoid overexertion and too much exercise.

Physical stress: Severe Covid-19 significantly affects the lungs and heart, potentially leading to reduced oxygen levels in the blood. Overexertion can further stress these organs, making the body’s recovery process more challenging.

Risk of complications: Overexertion can introduce complications, such as myocarditis (inflammation of the heart muscle), which is more common in Covid-19 patients. It can also increase the risk of blood clots and deep vein thrombosis.

Energy conservation: During recovery, rest plays a vital role. The body requires energy to combat the infection and repair damaged tissues. Overexertion can divert energy away from these critical processes.

Immune system response: Overexercising can temporarily suppress the immune system, rendering the body more susceptible to other infections.

Is Covid behind rising heart attacks?

Dr Goyal says there is some evidence that Covid-19 may be linked to an increased risk of heart attacks.

“A study published in the journal Nature Medicine found that people who had been hospitalized with Covid-19 were more likely to have a heart attack in the following year than those who had not been infected. The study also found that the risk of heart attack was higher among people who had severe Covid-19, says Dr Goyal.

“Around 15-20% of Covid patients are experiencing heart problems. The most common heart problem is a heart attack because of the increased tendency to form clots in the blood vessels. This means the arteries that send blood and oxygen to the heart get blocked, leading to a heart attack. In a minority of patients (3–5%), Covid directly affects the heart muscle, creating weakness in the heart muscles and leading to heart failure, called Covid-induced cardiomyopathy. Two things are happening because of Covid: one is direct damage to the muscles, which occurs in a lesser number of cases, and the second, which is much more important, is the creation of clots in the blood vessels. Those patients who already have blockages in the coronary arteries are more likely to develop blockages in the coronary arteries, leading to a heart attack. But in certain cases, even without previous blockages, normal coronary arteries become clogged because of Covid. So, the incidence includes both cardiomyopathy and the incidence of heart attacks, which is between 15-20%,” says Dr Dubey.

“Another study, published in the journal Circulation, found that people who had Covid-19 were more likely to have a heart attack or stroke in the following six months than those who had not been infected. The study also found that the risk of heart attack or stroke was higher among people who had had a severe case of Covid-19,” adds Dr Goyal.

“Although Covid-19 primarily targets the respiratory system, it can indirectly heighten the risk of heart attacks due to factors such as inflammation, blood clot formation, and stress on the cardiovascular system. However, Covid-19 alone isn’t the exclusive cause of the escalating incidence of heart attacks. Instead, some individuals with Covid-19 may experience heart-related complications, potentially contributing to a heightened risk of heart attacks. This underscores the importance of vigilance for individuals with pre-existing heart conditions and those in recovery from Covid-19,” Dr Kumar.

What kind of work severe Covid patients should avoid?

“Severe Covid-19 patients should also avoid any work that is stressful or mentally demanding. This is because stress can worsen inflammation and weaken the immune system. In addition, severe Covid-19 patients should avoid any work that puts them at risk of exposure to other people who may be sick. This includes working in close proximity to others, working in crowded places, or working in healthcare or other high-risk settings,” says Dr Goyal.

Dr Goyal says severe Covid-19 patients should avoid any work that is strenuous or physically demanding.

This includes activities such as:

• Heavy lifting

• Pushing or pulling heavy objects

• Climbing stairs or ladders

• Running or jogging

• Playing sports

• Working in hot or humid environments

“Severe exercise should be avoided. If the heart and lungs are involved, or if you have suffered a mild case of Covid without lung and heart involvement, you can engage in exercise without any problem. However, if you have lung and heart problems during Covid, you should avoid heavy exercise, such as running, jogging, or playing football or basketball,” says Dr Dubey.

“In the wake of severe Covid-19, individuals should steer clear of physically demanding or strenuous work that could result in overexertion. This encompasses activities like heavy lifting, extended periods of standing, or any tasks that significantly elevate heart rate and respiration. For precise recommendations tailored to one’s health status and recovery progress, consulting a healthcare professional is essential,” says Dr Kumar.

Tips for Covid survivors to take care of their heart

Covid survivors need to take good care of their health and adds loads of fibrous fruits, vegetables and whole grains to their diet. While strenuous activities should be avoided, it’s important to be physically active and maintaining a healthy weight.

“First of all, if a person experiences symptoms like breathlessness and chest pain during or immediately after Covid, even after a few months, they should get their heart examined. Consult a cardiologist and undergo an ECG and echocardiogram, which are simple tests for heart disease. If there is any problem with the ECG or echocardiogram, a cardiologist may recommend angiography. As for blood tests, there are two that serve as surrogate markers for the effects of Covid: one is CRP, which stands for C-reactive protein test, and the other is the D-dimer test for the tendency of clotting in the body. These tests should be done alongside the ECG and echo. If there is any problem with any of these tests, consult your cardiologist,” says Dr Dubey.

Here are some tips for Covid survivors to take care of their heart as per Dr Goyal:

• Eat a healthy diet. Eat plenty of fruits, vegetables, and whole grains. Limit saturated and trans fats, cholesterol, and sodium.

• Exercise regularly. Aim for at least 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous-intensity aerobic activity each week. You should also do strength-training exercises for all major muscle groups on two or more days a week.

• Maintain a healthy weight. If you are overweight or obese, losing even a small amount of weight can help improve your heart health.

• Quit smoking. Smoking is a major risk factor for heart disease. If you quit smoking, your risk of heart attack and stroke will start to decrease immediately.

• Manage stress. Stress can worsen inflammation and weaken the immune system, which can increase your risk of heart disease. Find healthy ways to manage stress, such as exercise, relaxation techniques, and spending time with loved ones.

• Get regular checkups. See your doctor for regular checkups and screenings for heart disease and other health problems.

Dr Kumar adds more tips to the list:

• Stay active, but in moderation: Gradually reintroduce physical activity into your routine, with an emphasis on avoiding overexertion. Gentle exercises like walking or yoga can be instrumental in the recovery process. It is advisable to aim for a daily step count of either 10,000 or 5,000 steps, as recommended by various reports. Additionally, engaging in regular moderate exercise for 30-45 minutes a day, along with two days of muscle training, is beneficial.

• Monitor blood pressure and cholesterol: Keeping a close watch on blood pressure and cholesterol levels is vital. If necessary, adhere to prescribed medications.

• Manage stress: Chronic stress can exert a detrimental influence on heart health. Implement stress-reduction techniques like meditation, deep breathing, or mindfulness.

• Limit alcohol intake: Excessive alcohol consumption can place undue strain on the heart. If you choose to consume alcohol, do so in moderation.

• Get sufficient sleep: Strive for 7-9 hours of quality sleep each night, as this is instrumental in supporting overall health, including heart health.

• Stay hydrated: Adequate hydration is fundamental for cardiovascular well-being.

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