GHA specialists monitor impact of Covid-19 on heart conditions

The impact that Covid-19 can have on patients with heart conditions is being closely monitored by specialists at the Gibraltar Health Authority.

GHA Consultant Cardiologist Dr Roger Moore said patients with existing heart conditions can experience additional complications as a result of Covid-19, an illness about which doctors still know relatively little.

“The virus may occasionally directly invade the heart muscle directly or more commonly cause an immune response which indirectly causes heart muscle inflammation,” he said.

“It can also cause inflammation of the sac that surrounds the heart.”

He added that in severe cases, Covid-19 infection can also place the heart under stress sufficiently to cause problems particularly in patients with pre-existing heart issues.

In these severe cases the virus can also provoke abnormal heart rhythms and raise the risk of heart attacks in some patients.

“Significant cardiac muscle damage has been reported in these more severe cases although this appears to be rare,” said Dr Moore.

In mildly symptomatic patients with Covid-19 he told the Chronicle that mild cardiac issues have been demonstrated using high resolution cardiac imaging.

“This has raised questions about longer-term effects of the infection particularly for patients who had not had previous cardiac disease,” he said.

“These mild changes however in themselves would not be expected to cause immediate cardiac issues and to date there are no evidence of significant numbers of these patients presenting with serious heart problems.”

“This however will need to be researched further,” he added.

Another issue with Covid-19 is that it makes the blood thicken.

Dr Moore explained that Covid-19-infection stimulates the body’s clotting system and can damage the lining of blood vessels making them more likely to activate the formation of clots.

“If a blood clot forms in a heart artery, it can reduce delivery of oxygen to the heart muscle and potentially cause a heart attack,” he said.

“The increased clotting tendency can also lead to blood clots in the lungs, which can cause a drop in blood oxygen levels.”

“If oxygen demand exceeds the supply level heart muscle will be affected.”

The likelihood of developing significant heart issues with Covid is directly related to the severity of the Covid infection, Dr Moore said.

“The likelihood of developing a severe Covid infection is in turn increased by risk factors such as male gender, obesity, diabetes, hypertension and the presence of previous significant medical conditions including those involving the heart and lungs,” he added.

In patients with severe Covid infections Dr Moore and the cardiac team in the GHA have seen all manifestations of heart involvement, he said.

“The characteristics of the patients we are seeing exactly mirror those that would expected to be at highest risk. That is, the elderly particularly men and those with previous health issues as discussed earlier,” he said.

“We have also seen patients presenting with heart attacks with a recent history of Covid-19 infection.”

“At present we have not seen any evidence of people with mild Covid-19 presenting with new serious cardiac problems though we are still in the early phase of this disease,” he added.

Dr Moore said people to improve their chances of avoiding serious complication from the virus by improving their cardiovascular health.

“Take regular exercise with a careful gradual increase in activity to maintain your target weight,” he said.
“Eat sensibly with a balanced diet including fish which is low in fat, sugar and salt and high in fibre and stop smoking.”