Dr H S Bedi, President of the prestigious Venous Association of India, is one of the senior-most cardiothoracic surgeons of the country in active practice. He has to his credit a number of heart-related innovations and has done important surgeries, including the multi-vessel beating heart surgery, using innovative techniques for stabilisation and perfusion with angiographic follow-up. Now settled in Mohali (Punjab), he has been associated with various prestigious hospitals like St Vincent Hospital, Sydney (Australia); the Royal Alexandra Hospital for Children, Sydney; Escorts Heart Institute, New Delhi and Fortis Heart Institute, Mohali.
In this interview with Syed Hashim Najmi, Dr Bedi talks on different aspects of our heart’s health, especially on the challenges faced by heart patients during Covid-19.
Excerpts:
Q. What should a heart patient do immediately if he is found to be infected by Covid-19? Should he consult his heart specialist before starting medication for the infection?
A: A heart disease patient is more at risk of complications and death if he gets infected by Covid 19. He should immediately consult his cardiologist besides his local doctor.
Q. Why is the life of a heart patient more at risk than others from Covid-19?
A: In the case of the Covid 19 infection, there is a high incidence of inflammation of the inner lining (endothelium) of all vessels, including those of the heart. This causes swelling and can precipitate a heart attack. The heart itself can get inflamed causing myocarditis. There is a very high incidence of blood clotting not only in the arteries but also in the veins – a hypercoagulable state. A clotting of blood in veins can cause a debilitating disease called deep venous thrombosis (DVT ) which, in turn, can lead to a potentially fatal condition called pulmonary embolism (PE).
Q. What kind of precautions should a heart patient take to remain safe from Coronavirus?
A: The precautions remain the same basic ones like wearing a good quality (N 95) face mask at all times, hand washing frequently, social distancing and full vaccination.
Q. It has been found that people with a pre-existing heart problem have very little chance of survival if found infected by Covid-19. Most people who are losing their lives during the current wave of the pandemic have a comorbidity like a heart ailment.Why?
A: The heart has no backup system. So, if the heart stops functioning even for three minutes, it would be fatal. Hence the poor results.
Q. What do you say about the new variant of Covid-19, Omicron, and its threat to heart patients?
A: This threat is being evaluated. As far as my experience goes, it is less threatening than the Delta variant. However, precautions must remain as before.
Q. Is it safe for heart patients to get anti-Covid-19 vaccines like any other person? Do such people require any extra precautions?
A: It is not only safe but also mandatory for heart patients to get vaccinated unless they have had a recent heart attack episode (within four weeks).
Q . What more should a heart patient do to protect himself from Covid-19 than an individual not having any heart-related problem?
A. Very strict isolation is life-saving. Avoid going out at all except for emergencies.
Q. Does maintaining a healthy lifestyle help a heart patient in remaining safe from Coronavirus?
A: Definitely. Although the patient should not mix with others, he must do exercises even inside his own room. Yoga is a good exercise to do alone. One can join online yoga classes. Do not avoid cardiac medications.
Q. Can Coronavirus cause heart problems in the case of those patients of Covid-19 who have had otherwise no history of heart disease?
A: Yes. It causes inflammation of the vessel lining and of the heart itself. The latter is called myocarditis. A study carried in The Lancet showed that the risk of a heart attack was three-eight fold in Covid-19 infection cases.
Q. Can a patient with active Covid19 infection undergo heart surgery?
A: We generally avoid any elective surgery in an active infection case. We decide to operate only if there is a true dire emergency like a heart attack not stopping with medicine or stenting or a trauma (knife injury to the heart). I have done a few surgeries in such cases, but elective surgeries should be avoided.
Q. What do you do if a post-Covid patient requires heart surgery?
A: If a post-Covid patient needs surgery, we wait for four-six weeks at least and make sure that the RT PCR test is negative. I have operated a fair number of post-Covid cases. Their lung function is also affected and that must be checked very carefully.