Taking Care Of Your Heart During A Pandemic

What top cardiac doctors have learned in a time of COVID-19.

“What we understand about COVID-19 is continuously evolving,” says Gary Rogal, MD, Chief of Cardiology at Saint Barnabas Medical Center (SBMC) and Medical Director of Cardiac Services at RWJBarnabas Health (RWJBH).

That’s why cardiac experts throughout the RWJBH system have ongoing discussions about the effects of COVID-19. In a recent webinar, Dr. Rogal moderated a discussion on the topic with his colleagues David Dobesh, MD, Director of Cardiac Electrophysiology at Jersey City Medical Center; Sarah Fan, MD, noninvasive cardiologist at SBMC; and Arash Salemi, MD, Clinical Chairman of Cardiothoracic Surgery, RWJBH Northern Region. (All four doctors are members of RWJBarnabas Health Medical Group.) Here are some of the things doctors have learned about COVID-19:

Cardiac patients are at higher risk of complications from COVID-19. “Patients who have coronary disease or congestive heart failure are at much higher risk for all the possibilities of COVID-19, such as respiratory and neurologic complications,” says Dr. Fan.

The better controlled a cardiac condition is, the better the patient will fare with COVID-19. Unfortunately, many people did not control their conditions well during the early part of the pandemic. “As a result, many ended up needing urgent procedures,” says Dr. Fan. “Taking care of your heart condition is more important than ever, for your overall health and in case you contract COVID-19.”

COVID-19 can lead to blood clotting, even in patients who had no underlying risk factors. “We see COVID-19 patients with clots in the legs, in the lungs or even the heart chamber, which is very rare,” says Dr. Fan.

“We are also seeing a higher incidence of strokes in COVID-19 patients.”

COVID-19 can lead to arrhythmia or atrial fibrillation (AFib). “AFib or arrhythmia by themselves do not appear to be risk factors. However, many patients who were hospitalized with COVID-19 developed them,” says Dr. Dobesh. “That may have been related to other COVID-19 complications, such as blood clots, high fever, low oxygen levels or severe pneumonia.”

Cardiac patients who are taking ACE inhibitors (medications to control high blood pressure) should continue taking them. “Early on, there was some discussion that ACE inhibitors would potentially increase the protein in the body that binds to COVID-19,” explains Dr. Fan.

“Since then, we have found there is no difference in the mortality rate for people who are taking ACE inhibitors. Don’t stop any medication unless you speak to your doctor first.”

COVID-19 will not affect the functioning of an implantable device, like a pacemaker or defibrillator. “The device will continue to work,” says Dr. Dobesh. “Keep monitoring it remotely. However, if you feel that your heart rate is elevated or you are alarmed about it in any way, do not hesitate to reach out to your physician.”

Cardiac patients should not fear being admitted to the hospital for surgery. “Given the current restrictions, protocols, regulations and procedures we’ve put in place in our hospitals, I can say that patients who come to us are as safe as they would have been in pre-pandemic days,” says Dr. Salemi.

“The units we utilize are separate and have not been exposed to COVID-19. Admissions or readmissions are a low-risk scenario.”

To see the full webinar, go to www.rwjbh.org/sbmcwebinars.

Your heart doesn’t beat just for you. Get it checked. To find a cardiac specialist at Saint Barnabas Medical Center, call 888.724.7123 or visit www.rwjbh.org/heart.