COVID-19 and People Living with Heart Disease

Advice from the Global Heart Hub

It is understandable that those living with various heart conditions are anxious and concerned about the Coronavirus.

While people of all ages can be infected by this new virus, it presents a greater risk for people over the age of 60 years of age and those who have underlying medical conditions, particularly heart disease, high blood pressure and diabetes.

It is well established that many virus infections can affect the heart, and coronavirus is no different. Viruses are known to cause inflammation of the heart muscle. While in a healthy patient this may not lead to an adverse outcome, the situation for those living with heart disease is different. If these individuals become infected with coronavirus they are at greater risk of adverse cardiac events and the outcomes may be poor.

It is normal to feel concerned about COVID-19, especially if you are living with a heart complaint. While it is normal to feel anxious about how this condition might affect you, the first thing to know is that you are at no greater risk of developing COVID-19 than anyone else. However, if you do contract the virus you have a higher chance of developing complications.

With the number of cases increasing on a daily basis, hospitals are likely to experience an unprecedented increase in-patient admissions. Consequently, in anticipation some hospitals are cancelling clinics and limiting non-urgent activity to urgent and emergency cases so as to reduce the strain on staffing and beds.

It is important to remember that our hospitals will continue to treat heart patients, but the current pressures may result in delays, cancellation of appointments and disruption of services.

How do I reduce my risk of contracting the COVID-19:

For those living with heart disease, prevention is key. Currently, there is no vaccine to prevent COVID-19 and the best way to prevent illness is to avoid being exposed to this virus.

Coronavirus is spread by droplet infection – coughing and sneezing – or by close contact with someone who has the virus. As this is a new illness, we do not know how easily the virus spreads from person to person. Spread is most likely from those who have symptoms. It is very important therefore to limit close contact.

Individuals with heart conditions or people living with someone who has a heart condition need to be extra vigilant, be aware of the symptoms of coronavirus and take the recommended precautionary measures.

Key things to remember are:

• Wash your hands regularly with soap and hot water – do this for at least 20 seconds at each wash.
• Use hand sanitiser gel if soap and water are not available.
• When you cough or sneeze, cover your mouth and nose with a tissue or your sleeve (not your hands). Immediately after use, put your used tissues in the bin and then wash your hands.
• Avoid close contact with people who are unwell.
• Do not touch your eyes, nose or mouth if your hands are not clean.
• Do not share objects that touch your mouth, for example bottles or cups.
• Do you best to follow all your medical advice on how to keep your condition well controlled.
• Stay in regular contact with family, friends or neighbours as you may need to ask for help if you become sick.
• Maintain a healthy diet – unless you have been advised to adhere to a specially prescribed diet, you should continue to try and eat a wide variety of foods that are rich in vitamins, minerals, fibre and other essential nutrients.
• Try and engage in some form of exercise everyday – even if it is only walking up and down the stairs if you are able.

For Family and Caregivers:

• Know what medications are prescribed – maintain a list.
• Watch for new symptoms.
• Prepare a plan to make sure food and other supplies are available when needed.
• Consider options and have a plan for what would happen if you become ill.

International cardiac specialists are offering the following advice for specific heart conditions:

• Individuals who are immunosuppressed, such as heart transplant patients or cancer patients who also have heart disease are probably the most vulnerable to this virus and need to be extra vigilant.
• There is no evidence to-date that the virus infects implanted devices such as pacemakers and cardioverter defibrillators or causes infective endocarditis in those with heart valve disease.
• Individuals with Brugada Syndrome need to treat fever aggressively and try and keep body temperature below 39 degrees Celsius.
• Individuals who have previously suffered from myocarditis or pericarditis are not at any higher risk of developing the same condition with COVID-19.
• To-date there is no evidence that the coronavirus directly infects the heart, however the infection caused by the virus may worsen heart function and exacerbate symptoms in patients with heart failure.
• For the general population, wearing a mask is only recommended if you are experiencing symptoms or caring for someone with symptoms. If you have a heart condition, wearing a mask may make breathing more difficult so you should consult your doctor for advice on this.
• All those with heart conditions who are on medications should take all their medications exactly as prescribed. Do not make any changes without firstly contacting your doctor or nurse.

Despite all the focus on coronavirus, it is important to remember that heart attacks and strokes will continue to occur in our community. It’s important therefore to be aware of the signs and symptoms of heart attack and stroke and to take immediate action. If you or someone with you experiences chest pains or stroke symptoms, do not delay in calling the emergency services.