Rise in heart attack cases in youth alarms doctors in Andhra Pradesh

Visakhapatnam: Cardiac patients are generally reported to be older, but several youths have died of sudden heart attacks in recent times in Andhra Pradesh. While a section of medical experts suspect the role of COVID-19-related myocarditis and pericarditis, the theory is yet to be established with substantial data.

Myocarditis can present a range of symptoms from chest pain and dyspnoea to acute heart failure. According to a recent study published in the ‘Nature Medicine’ journal, even a mild case of the COVID-19 disease can significantly increase the risk of heart disease.

The study highlighted post-acute sequelae of COVID-19 related to pulmonary and extrapulmonary organs, including the cardiovascular system.

Based on various recent studies, the COVID-19 pandemic seems to not only have presented the pressing challenges of prevention, treatment, and management of a new disease to humankind, but also a constellation of symptoms post recovery.

According to experts, SARS-CoV-2 – the virus responsible for the COVID-19 disease – can enter a variety of human cells by binding it spike protein, including the endothelial cells in coronary vessels, cardiomyocytes (cells responsible for the contraction of the heart), and alveolar cells. This could partly explain the pathophysiology behind the COVID-19 induced myocarditis in some patients.

Director, Visakha Institute of Medical Sciences (VIMS), Dr K Rambabu said that there are little doubts regarding the role of SARS-CoV-2 in these heart attacks and deaths. “COVID-19 is known to elevate D-dimer levels and cause clotting abnormalities in some patients, perhaps leading to the cardiac abnormalities.

In some people who recovered from the pandemic disease, bilateral avascular necrosis is also reported. These abnormalities are surfacing irrespective of the dosage of steroids given to the patients during their COVID-19 recovery,” said Dr Rambabu.

He added that those who have contracted COVID-19 and have comorbidities have to closely monitor their health. They should undergo certain screening tests, he added.

Cardiothoracic surgeon Dr C Prabhakar Reddy said that the incidence of exercise-induced cardiovascular events has increased in the youth and middle-aged people. “But there could be several underlying factors for it. It is better for people aged 40 or more to undergo cardiac screening before starting gym activities or intense exercises,” said Dr Reddy.