Timely care is key to survive heart attack in Covid-19 times


Heart attacks are more likely in Covid-19 patients. Reasons can be low blood oxygen levels, tendency to form blood clots, inflammation, stress and micro vascular dysfunction. This is especially true for moderate to severe cases, those with very high D-dimer value and low oxygen levels. This warrants stronger blood thinners (anticoagulants) during Covid-19 as well as three to five weeks after recovery. If immediate medical attention isn’t given, there may be permanent heart damage or a cardiac arrest, causing death.

Heart attack is said to be one of the leading causes of death worldwide. Most of these deaths take place because proper first aid or medical attention is not given. Even in a pandemic, do not delay. Hospitals are taking utmost care to treat patients in a safe and segregated environment.

Firstly, one should know when to suspect heart attack — if a person starts having severe crushing/compressing pain in central chest and/or shoulders, lower jaw, upper back, usually associated with profuse sweating, typically for over 15 minutes. Some patients (especially diabetics) have silent or painless heart attacks. Other symptoms are shortness of breath, belching, weakness, dizziness. Once heart attack is suspected, patient/family members should know what to do. Mostly, people delay treatment, as they disbelieve that symptoms are of heart attack, mistaking it for acidity or muscular pain, as they don’t want to cause inconvenience to the family at odd hours or due to financial constraints.

The following points must be remembered in case of a heart attack:

  • Every moment is precious, so act fast. Do not leave the person alone and don’t try to manage at home. Even if the person feels a little better, he/she must be taken to the nearest hospital as early as possible. There is no household remedy for heart attack. Keep the person in lying down posture, loosen his clothing and rush him to the nearest hospital. Meanwhile, make him chew one full tablet of aspirin.
  • Give one 5mg sorbitrate tablet under the tongue. If there is profuse sweating, cold extremities, that is, drop in blood pressure, then don’t give it.
  • If the patient is breathless, recline partially and make him cough intermittently.
  • If the person is unconscious and unresponsive, cardio pulmonary resuscitation (CPR) should be performed. Give chest massage as well as mouth-to-mouth respiration.
  • Do not depend on a home remedy for benefits. Do not go to outpatient clinic of a doctor. Reach the nearest facility which has ICU or advanced treatment facilities for heart ailments. Immediately, get the vitals (BP, heart rate and oxygen saturation) checked and get an ECG done.
  • Do not sit on consent issues. Give blanket consent for fast treatment facilitation in a crisis situation; let the experts act. Remember, it is a do-or-die situation in crisis.
  • Options are clot buster/blood thinner medications or angiography and primary angioplasty/stenting (most ideal). Primary angioplasty gives ideal results immediately after a heart attack in the first 90 minutes.
  • Do not fall prey to non-scientific modes of treatment.

The author of this article is Dr Vineet Malik, MD (AIIMS), DM Cardiology (AIIMS), gold medallist, FNB Interventional Cardiology (Escorts Hospital), senior consultant, Interventional Cardiology, Maharaja Agrasen Hospital, Punjabi Bagh, New Delhi.

Disclaimer: The veracity of any health claim made in the above article is the responsibility of the concerned hospital/doctor.

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