Care of Cardiac patients during COVID-19 pandemic

 What is the need?

Till now it is very clear that COVID-19 disease behaves differently among different subsets of patients. The disease tends to be relatively mild and self-limiting in younger individuals but  it tends to take on a rather sinister course in the elderly and several others with risk factors like  pre-existing cardiovascular disease, hypertension in addition to age and diabetes have emerged as fairly strong associates of a poor outcome in patients with this disease. Presence of CVD is associated with increased mortality in COVID-19 infections, hence they need to take extra care to prevent infection. 

Instructions to patients with specific heart disease:

Patients with heart failure-

• Should maintain their salt & water restrictions as before.
• Should periodically monitor their health by watching weight, urine output, effort tolerance etc. to identify early decompensation as advised by the cardiologist.

Patients who have coronary stents in situ-

• Should continue anti-platelet drugs as advised as before since stopping them can result in recurrent MI & sudden death.

Patients on anti-coagulant therapy-

• Should have their RT-PCR done & get their dose titrated by cardiologist over phone.

General instructions:

• Always be in positive outlook.
• Follow healthy habits & lifestyle as advised.
• Continue the already advised dietary modifications & restrictions by cardiologist.
• Keep active inside home with simple exercises like short walk.
• They are advised to strictly continue the prescribed medications as before by cardiologist.
• They should avoid routine consultations but call or consult to the doctor whenever needed.
• They should stay at home, maintain social distancing, wash the hands with soap & water.
• Sanitization of frequently touched surfaces should be done regularly. 
• They should take adequate rest.
• Stop alcohol & smoking.

When to seek emergency care?

• If they develop any COVID-19 symptoms like fever, throat pain, breathlessness, Generalized body ache, new loss of taste or smell, chest pain, diarrhea, abdominal pain etc.
• Any cardiac symptoms like chest pain/pressure, especially during exercise, facial dropping, arm weakness/numbness, speech changes, loss of vision, severe headache, breathing difficulty at night associated with leg swelling, dizziness, fainting etc.

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References:

1. Covid-19 pandemic: focused recommendations for management of cardiac patients, National health mission, Tamil Nadu.
2. https://www.world-heart-federation.org/covid-19-and-cvd/
3. https://www.heartandstroke.ca/articles/coronavirus-heart-disease-and-stroke
4. https://journals.sagepub.com/doi/full/10.1177/2047487320925632
5. https://www.pennmedicine.org/updates/blogs/heart-and-vascular-blog/2020/june/keeping-your-heart-healthy-during-covid
6. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESC-COVID-19-Guidance
7. https://www.ohsu.edu/knight-cardiovascular-institute/my-heart-healthy-plate photo credit
8. https://www.vectorstock.com/royalty-free-vector/incoming-call-on-mobile-phone-vector-23305059 photo credit
9. https://depositphotos.com/23893445/stock-photo-cute-woman-sleeps-on-the.html photo credit