From the very beginning COVID-19 pandemics, it quickly became clear that SARS-CoV-2 could cause damage to the cardiovascular system. From thrombus formation, dysfunction of the vascular endothelium, activation of inflammation, up to a direct heart attack.

As professor of cardiology Georgios Kochiadakis and future president of the Hellenic Heart Association notes in an interview with APE-MPE, we can indeed say that the pandemic, mainly in the first three waves, had the most adverse effect on overall cardiovascular morbidity and mortality. population in our country, mainly through three determining factors.

The pandemic has increased morbidity and mortality in heart patients in three ways

1. Mr. Kochiadakis claims that the avoidance of contact with the healthcare system by a significant part of the population due to fear of exposure to the virus has led to “an increase in the incidence of serious complications of myocardial infarction due to late attendance or even sudden death at home.”
2. The pandemic has also contributed, he points out, to the depletion of the existing health system infrastructure for the treatment of cardiovascular diseases, “both in terms of dealing with emergencies, and in the field of primary and secondary prevention.”
3. Finally, due to the restrictive measures that had to be introduced to slow the spread of the virus, “the healthcare system itself did not go unnoticed (temporary closure of outpatient clinics, postponement of non-urgent therapeutic interventions, complex management of patients with acute cardiovascular diseases who were simultaneously affected by the virus).

With the exception of the impact of the first waves of the COVID-19 pandemic on the severity of acute cardiovascular events due to the difficulties of their timely and optimal treatment, “their outcome is clearly getting better over the years. The main change in the profile of people hospitalized with acute myocardial infarction or stroke is associated with an increase in life expectancy and a gradual aging of the population, as a result of which we are progressively dealing with older people with multiple comorbidities.” indicates Mr. Kochiadakis, talking to Michalis Kefalogiannis.

New ‘heart attacks’ in young people

However, as he emphasizes, advances in diagnostic methods in the last few years “have also brought to the fore new phenomena that could be included under the term ‘heart attack’ and that usually concern young people who were previously undiagnosed, with automatic division of the coronary arteries. as a representative example.”

However, it is specified that the population most vulnerable to acute cardiac events is those with multiple established cardiovascular risk factors, namely age (men: >55 years, women: >65 years), diabetes mellitus, hypercholesterolemia, smoking, hypertension, obesity and family history of early cardiovascular disease or sudden cardiac death in young people;

“In addition, the identification of people with low socioeconomic status as a group prone to acute cardiovascular disease should not be overlooked,” he says.

Smoking remains number one on the list of heart attack risk factors

As the future president of the Hellenic Society of Cardiology says, “There is no doubt that smoking is one of the most important – and, especially in people under 50 years of age, the most important – modifiable risk factors for serious cardiovascular disease.”

However, he explains that in order to see the positive effect of smoking cessation, which has been observed in recent years in our country, it will take some time.

In particular, he emphasizes: “If we take into account that people for whom smoking alone is a risk factor for cardiovascular disease, these are mainly young people under 50 years of age, and not the elderly, who have more frequent episodes, we understand that For example, if the number of smokers in our country were to be halved in one year, then it would be scientifically incorrect to expect a 50% decrease in the annual incidence of myocardial infarction even after 5 years.

How big is the role of stress in cardiovascular disease?

Mr. Kochiadakis was asked why people, despite information about cardiovascular disease, do not change their lifestyle and cannot control acute and chronic stress.

“I think that the difficulty that people with an average level of education can have in distinguishing between reliable and invalid sources of medical information can play an important role, especially given the disproportionate availability of information today. Acute stress may indeed be a trigger, i.e. cause, of CV events, but the association of chronic stress with CV risk is also weaker than that of established CV risk factors and may be, to some extent, indirect. For example, in today’s fast-paced Western culture, stress at work or at home can leave people with less space to deal with their health in an organized way and changes in risk factors for cardiovascular disease, such as smoking.”

The heart attack revolution continues

It is clear that the availability of diagnostic and therapeutic methods with an increasingly favorable balance of benefits and side effects is great news in the field of cardiovascular medicine, concludes Mr. Kochiadakis, emphasizing that “optimal and timely treatment of acute myocardial infarctions helps to minimize their short-term and long-term consequences. An increasing number of patients retain cardiac function after an episode.

But for a person who has had a heart attack, it is extremely important to adhere to the recommended lifestyle – not smoking, strict control of cardiovascular risk factors, physical activity – and to adhere to the medication regimen, and this will not change in the foreseeable future. future future.

The term “as if nothing had happened” is only valid if it is used to describe, in this case, the effects of a rapidly cured heart attack on cardiac function.”