There are many aftermath of Covid, especially on the heart. Chest pain, palpitations and changes in the heartbeat, but also fatigue and breathing difficulties are a problem for 10-30% of infected patients, even 4 or more months after the infection resolves. There is a long cardiovascular-only Covid, classified with the term Pasc (Post Acute Sequelae from Sars-Cov-2) by the experts of the American College of Cardiology, which has just published a consensus document in the ‘Journal of the American College of Cardiology’ indicating the way to go to face the long Covid to the detriment of the heart.
The document should become a guide, which will also be followed on this side of the ocean, underline the experts of the Italian Society of Cardiology (Sic), calling attention to the opportunity to undergo a correct diagnostic procedure in the presence of cardiovascular symptoms after Covid and also the importance of using correct physical activity as an effective method to get back to being healthy.
“Long Covid at the cardiovascular level is now identified as Pasc: there are so many cases of patients with cardiovascular involvement after acute infection that a new disease has been defined – explains Ciro Indolfi, Sic president and full professor of Cardiology at the University Magna Graecia di Catanzaro – We speak of Pasc-Cvd when after the diagnostic tests a real cardiovascular disease is identified, or of Pasc-Cvs or Paschal syndrome when instead the standard diagnostic tests have not identified a specific cardiovascular disease, but are you have typical symptoms such as tachycardia, exercise intolerance, chest pain and shortness of breath “.
“Unfortunately, there seems to be a ‘downward spiral’ in long Covid, as American colleagues have defined it – he continues – fatigue and reduced exercise capacity lead to a decrease in activity and bed rest, which in turn entail a worsening of symptoms and a reduced quality of life “.
“Cardiac counseling is recommended for patients with Pasc and abnormal cardiac test results, in those with known cardiovascular disease with new or worsening symptoms, if the patient has had documented cardiac complications during Sars-CoV-2 infection or persistent cardiopulmonary symptoms that are not otherwise explained – resumes the expert – In the presence of Pasc syndrome, in which therefore there is no cardiological disease, but there are symptoms such as tachycardia or a reduction in training capacity compared to before the infection, Exercise in a lying or semi-recumbent position, such as cycling, swimming or rowing, is recommended initially, and then moving on to standing exercise as the ability to stand without wheezing improves. should be short initially (5 to 10 minutes per day), with gradual increases as functional capacity improves. also the intake of salt and fluids, to reduce symptoms such as tachycardia, palpitations and orthostatic hypotension; in some cases the doctor may prescribe beta-blockers, non-dihydropyridine calcium channel blockers, ivabradine, fludrocortisone and midodrine. “
“The important thing is not to neglect cardiovascular signs and symptoms – recommends Pasquale Perrone Filardi, Sic president-elect and full professor of Cardiology at the Federico II University of Naples – that appear or persist after 4 or more weeks of healing from Covid-19”.
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