I had Covid-19. Will I have heart problems in the future?

If I want to keep my heart healthy, what are the basic rules?

1. Everyone above the age of 40 should see a cardiologist once a year because cardiovascular diseases are progressive with age and a lot of times they will not present symptoms until it is too late.

. Signs to check out for include:

· Left-sided chest pains

· Pain in the left arm

· When you exert yourself you get tired easily or experience chest pains

· Palpitations

· Fainting episodes 

· Swelling of the legs, associated with difficulties lying flat on the bed

· Need to elevate yourself or be in a semi-seated position while sleeping because you cannot breathe well

Why do you think heart diseases are a leading cause of death in Kenya?

There are many aspects to this. One, we have an emerging silent pandemic. We used to think cardiovascular diseases are diseases of the rich, but now we are learning that because of the epidemiologic shift that is happening in Africa and developing countries, these diseases that we used to think are diseases of the rich or the West are now catching up with us. It could be because of socioeconomic changes or the fact that we have also changed a lot of our cultural practices into sedentary living and even our food has changed. As a result, we are seeing more prevalence of obesity, diabetes, high blood pressure and diseases of cholesterol or lipid abnormality in the blood. These are diseases that directly cause the rise of cardiovascular diseases. If you ask me, the numbers could even be higher, because we are still at the screening level. We should also be cognizant of the fact that we have more specialists and medical doctors – not necessarily specialists – who can diagnose these diseases. We also have the better diagnostic infrastructure, which has improved our diagnostics and has helped us to catch these diseases.

How can I protect myself if I have a family history of heart complications?

It starts with awareness. You need to understand the health conditions that exist in your family. Cardiovascular diseases tend to be passed through families. Some have a very strong genetic predisposition, like people having premature coronary artery disease, lipid disorders, and diabetes. These have a very strong family link. If you know someone in your family has a particular condition, you need to be watchful. At least, you have to go for more frequent annual screenings and you may need to begin these screenings earlier.

It is important that the clinician taking care of a person with cardiovascular disease gets to the bottom of it to establish the cause so that they understand the cause and evaluate the risk so that they know how frequently they should follow up the patient, how many of the family members need to be screened, how often, among other things. It is all about getting an index case and understanding the genetics around it.

Viagra and heart issues. Is the pill bad for my heart?

The mechanism of action of Viagra, the way it works, is that someone with a preexisting cardiovascular disease can be affected by Viagra and it can be detrimental in this case, and they need to be excluded from taking the drug. That boils down to the fact that it is very irresponsible to get Viagra over the counter. Before we prescribe Viagra, we, as clinicians do an assessment. We make sure the preexisting cardiovascular disease if it is there, will not be affected. Remember, we use Viagra to treat some conditions, such as high pressure in the lungs, which is called pulmonary hypertension. So, the use of Viagra has to be a well-coordinated, well-evaluated indication and we remove the contraindication – if it exists then we don’t prescribe the Viagra to the patient.

With the Kenyan culture, people do not conduct their cardiovascular evaluations annually, so these conditions are not picked. Additionally, the symptoms of erectile dysfunction could be an indicator of a problem in the heart, so by taking Viagra you are taking something to treat something that could be telling you there is a problem with your heart. 

Should I worry about any long-term effects on my heart in case I contract Covid-19?

We have seen that Covid-19 is a multisystem disease. It affects many organs, not just the heart. Concerning the heart, we are still learning, but we know that Covid-19 affects the heart immensely and can cause heart attacks, which can leave patients with heart failure. Covid-19 can also cause inflammation of the muscles of the heart and that can have its own implications, where someone would have arrhythmia and problems with the heartbeat. We are still learning about this disease, but we know it does affect the heart. The long-term effects are what we are still studying, but we know all the acute or immediate complications on the heart can cause long-term effects. A lot of data is coming out showing that Covid-19 is a disease we should watch out for. We are seeing that Covid-19 is more peculiar and has interesting effects on the heart, compared to the effects other viruses have on the heart. Why there has been an increase in heart issues among the youth

There are some lifestyle contributing factors like:

· Children are not playing outside because our cities are concrete jungles

· There are more cases of childhood obesity, childhood diabetes, and childhood hypertension. It is not a peculiar thing. It is just that our epidemiologic transition is happening and we are seeing more diseases that used to happen later in life starting earlier. For instance, cardiovascular disease occurs due to risk factors, and these risk factors are happening earlier in life so younger people are getting cardiovascular diseases.

Do I have to worry about my heart’s condition if I have high blood pressure?

High blood pressure is one of the risk factors for heart problems.  High blood pressure and other risk factors such as diabetes, weight problems in this case obesity, and cholesterol issues contribute to accelerated Atherosclerosis. This is the narrowing of blood vessels through the deposition of cholesterol or thickening of blood vessels. Eventually, this poses the risk of stroke, heart attack and all those complications. Blood pressure is not a joke. I tell my patients that it is a silent killer. The problem with high blood pressure is that you feel nothing when your blood pressure is elevated, that is why you see people just falling down and dying because they got a bleed in the brain or get a heart attack and things go haywire.

What is the ideal diet for a healthy heart?

I will summarise it in an easy, Kenyan-friendly way: Let us go back to how we used to eat as Africans. We were active, had very little processed food, and different styles of cooking. What I would discourage is the heavy use of starch. People used to consume a lot of starch but they used to burn it by having a lot of physical activity. Our African way of eating preserved us for a long time, until we got westernised and adjusted our eating habits to fit what we consider good living. What we consider good living is a dietary contributor to cardiovascular disease.

Diet is not just about what you eat, but also how it is cooked and the portions you will use and what you do after eating. During this Covid-19 period, many people have put on weight because they are working from home and have minimal physical activity, all factors that contribute to the risk of cardiovascular disease.