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Mumbai: Rise in heart attack post Covid or vaccination cause for concern

A rise in stroke and heart ailments has become a matter of concern for health experts. This is after a recent study, published in an international health journal, unmasked clinical features of ‘long Covid’ which suggest cardiovascular complications among Covid-19 patients, including acute coronary events, myocardial injury, and heart failure, can be prevented with timely intervention and routine check-ups.

“Covid-19, being a new pandemic, still has many unknown symptoms and sequels. The coagulation of blood in vessels that supply oxygen to vital organs such as the heart, brain, kidney, liver, long bones and joints, etc has challenged the care and hospitalisation of patients in different stages of Covid. Although many cases of minor clotting causing heart attacks and strokes don’t get reported, it is becoming increasing common with subsequent episodes of Covid or each additional dose of vaccine,” said Dr Subhash Hira, professor of Global Health at University of Washington-Seattle and an Advisor to WHO-Geneva.

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Developing countries reporting more cases

He added, “A recent Lancet study has shown low figures of adverse cardiovascular and stroke events among Covid patients at 2 per 1,000, while the recent ICMR study has put the number at 26 per 1,000 cases in India. Similar high adverse events were reported from several other developing countries too, as per the ICMR studies. The most common features of adverse events were coronary artery disease (10.9%), heart failure (5.5%), stroke (3.7%) and arrhythmia (3%) in a study conducted on 25,500 patients across 40 countries, as reported by Lancet in their recent study.” “Early treatment with non-steroid anti-inflammatory medicines provides fairly quick resolution when combined with blood thinners,” Dr Hira said.

Type of vaccine matters

Dr Wiqar Shaikh, professor of Medicine at Grant Medical College and Sir J J Group of Hospitals, said that a study from the United States Food and Drug Administration (USFDA) published in Lancet on June 11 has reported a risk of myocarditis (swelling of the heart muscles) and pericarditis (swelling of the covering of the heart) in people who have received Covid-19 vaccines—either the Moderna or the Pfizer vaccine, both of which are mRNA-based vaccines.

Dr Shaikh said, “The results of the study revealed that of the 1.5 crore people analysed by the study, 411 developed either myocarditis or pericarditis or both, unfortunately young people are affected and the risk was highest in the population aged 18 to 25 years.” Dr Shaikh clarified, “All reports regarding myocarditis and pericarditis are following mRNA vaccines. Citing that of the vaccines used in India, Covishield is a viral vector vaccine whereas Covaxin is an inactivated virus-based vaccine, he said India’s plan to roll out its own mRNA vaccine could be a cause for concern.’’

Early detection and treatment

Dr Pankaj Titar, former Covid medical officer, Kharghar, said, “Once a person gets infected by Covid-19, the virus starts causing inflammation wherever it gets to bind with ace-2 receptors. And these receptors are present on the endothelium, which forms the inner lining of the blood vessels surrounding the heart, thereby causing inflammation and risk of thrombosis (clotting of blood). This may give rise to heart attack or stroke.”

Dr Santosh Bansode, Head of the Department, Emergency Medicine, Wockhardt Hospitals, said, “It is published in the Lancet journal that thrombotic events are found to have increased in people who were infected by Covid-19. These events decrease over the period of one year after infection. So those who had Covid in the past or those who had taken Covid vaccine must be watchful at least for a year. Early evaluation is important to avoid complications.”

Symptoms to look out for

>> Breathlessness on exertion
>> Chest pain on exertion or at rest
>> Uneasiness or heaviness in chest
>> Unilateral leg swelling
>> Any limb weakness, slurred speech, facial asymmetry

26
Cases of adverse cardiovascular and stroke events per 1k Covid patients


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