Is there a relationship between COVID-19 vaccine and heart attacks? Dr Sriram Nene break it down

Dr Shriram Nene, a cardiothoracic surgeon, recently launched his YouTube channel to talk about various health issues. The healthcare innovator, who is married to actor Madhuri Dixit, shares informative health snippets on his social media handles. In an exclusive interview with Firstpost, Dr Shriram Nene talks about the pandemic, how the new COVID-19 variant is impacting the heart, his plans to reach out to far more patients through social media, and more. Excerpts:

COVID-19 cases are again increasing. What do you have to say about it?

Indeed, they are increasing worldwide as well as in India. The US has a record number of cases of almost 800 thousand to millions in one single day. If there is any good news about the Omicron variant which was first reported in South Africa, it is that it appears to be less toxic. Basically, it's not causing the level of lung imperilments that the Delta virus did. The result of what we are seeing is that it's twice more transmissible than the Delta variant and has less than half of the lethality. There are not a lot of ICU admissions or huge number of deaths from this.

It is noted that this variant has up 50 mutations, meaning that people will get it but it will just be like flu. There is no real hundred per cent protection but the booster does improve the chances of not getting it or getting mild form of it. So, the process is the same — get vaccinated, wear a mask, get out only if you have to and then if you get infected, you need to quarantine.

How bad is this new variant for heart patients? 

There were some reports of clotting after usage of Astrazeneca, specifically, but when they analysed the data it was no greater – 30 cases in 5 million patients. I have not seen a lot of data that shows the COVID-19 vaccine cause heart attacks directly. Having said that, there is a question if you have an underlined heart disease and you get the flu or viral or inflammatory syndrome after vaccination, could it increase the work of the heart – it is possible, but not related.

Is there a relationship between the COVID-19 vaccine and heart attacks?  

There have never been any documents that show a connection between vaccines and heart attacks. In the case of the Pfizer vaccine in young males, there were some incidences of mild Myocarditis which is swelling of heart muscles but it was usually self-limited and patient got better on their own. The second thing is — with the AstraZeneca and with the Covidshield vaccine there were small incidents of increased clotting reported, in particular in Europe. They stop allowing AstraZeneca for patience below 40. In Germany, anyone below 60 years, was not given AstraZeneca after the German medicines regulator found 31 cases of a type of rare blood clot among the nearly 2.7 million. The question is that does it translates to heart attacks. I have not seen any specific evidence suggesting any of the vaccines have led to heart attacks.

Younger people are getting heart attacks? Tell us the reason behind it.  

We know about the risk of premature heart diseases in people in their 40s. In 2004, it was documented by several researchers in India. Where they look at population-based study, what they found is that the males, in particular, have risk of heart diseases 10 years earlier than their Western counterparts in their late 30's and early 40's. In addition,  they have diabetes, increased stress, obesity — the major risk factors. I think when you look at getting younger people heart attacks, what you have to do is identify the risk factors. If you have a history of family members getting it below the age of 50, if you have high cholesterol, diabetes, high blood pressure is, history of heart disease or had a heart attack before, then the risk of you getting it again is higher. The second thing is you have to look at your lifestyle, you have to look at all the parameters like obesity, energy dense food. So, I think we can identify all these then can prevent it. I think we need to talk about this openly and help people recognise what are the risk factors, how you can prevent it, and what you have to do if you are having symptoms.

How can one know symptoms? 

There is typical and atypical symptoms. In general, the typical symptoms are chest pain, pain in the left arm, shortness of breath, sweating which comes on suddenly. In addition, there is atypical symptom like dyspepsia heartburn. It can also be some pain in your back or you can have no symptom in 15 to 20 per cent of cases. Only way to prevent this is to recognise what the risk factor is. Women often have small arteries than men, so the blockages from the percentage standard are higher. And their outcomes are worse. If you have asymptomatic symptoms or have risk factor, please go and get evaluated and start talking about it.

How important is diet when we talk about staying healthy?

You are what you eat, as the saying goes. Ultimately, I think that if you can engineer a lifestyle that has a number of things then it's alright:

1. Watch what you eat
2. Control your weight: 80 to 90 percentage of weight control can be regularized by the food you consume and not exercise. Exercises are 10 to 20 per cent, at most. The key is a balanced diet. Avoiding food that is rich in fat and combining the diet with carbohydrates that match your level of activity and proteins will allow you to build muscles. Coupled with a good exercise regime. Exercises also differ as per your age. In general 100 to 150 minutes a week for adults. That what usually 30 minutes 5 times a week, if you can do it.

The availability of processed food which is very energy-dense has led to bad outcomes. You can get overweight very quickly and it's very hard to shut that.

Tell us something about your YouTube videos on health? 

The bigger plan for me was creating a platform to help people gain awareness and access to world class evidence-based medicines. We have been working on that for some time. It got accelerated in pandemic because lot of things were going straight from preprint servers to the headlines.

The problem with that is information was not pre-reviewed and a lot of people were panicking after seeing the headline. So, what we said is: it would be great to put together something which was easy to consume and at the same time act like good evidence. In our YouTube pieces in description. We put all the links from credible journals, credible sources.

It is part of bigger platform that we are creating with media, technology and smart services which hopefully will improve awareness about world-class medicine, and at the same time help out the patience, doctors, and medical institutions to take care of everyone in a timely fashion.

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Eshita Bhargava