Are Covid boosters safe enough? What’s causing sudden heart attacks among young Indians?

Pavitra Utgikar speaks to Dr Atul Limaye, Senior Interventional Cardiologist from Fortis Hospital in Mumbai on the increasing incidents of heart attacks in the country.

Dr Atul Limaye, Senior Interventional Cardiologist, Fortis Hospital, Mumbai, speaks to The Probe’s Pavitra Utgikar on the reasons behind the increasing instances of heart attacks in the country.

Pavitra: Covid-19 boosters have been at the centre of discussions related to these rising instances of heart ailments. There are too many speculations. What, according to you, is the reality?

Dr Limaye: Now you are going to get me into trouble (laughs). This is a very controversial topic, but I will tell you what science has gathered in a very unbiased manner.

The answer is very nuanced from my reading of the literature. There is no doubt that the vaccines have been a tremendous success in reducing the risk of hospitalisations and the risk of severe Covid. There is no doubt about it. I think that it is also unquestionable that folks who are immunocompromised and who are at the highest risk of getting bad effects of Covid-19 or getting bad Covid pneumonia or being hospitalised are definitely helped by this vaccine.

Where does the nuanced part come in? The nuanced part comes in young, healthy adults where there have been some recent studies, particularly out of the US where the mRNA vaccines are in vogue, which has shown that the mRNA vaccines have had some high incidence of Myocarditis, particularly in young adult males. Males who are less than 20 years of age. So, the nuanced answer to your question is that yes, you need to be careful when you are doing boosters.... Especially the third booster or the fourth booster in otherwise young healthy males.

But if you are over the age of 60, you have diabetes and obesity, and you have risk factors that put you in a high-risk bracket for a Covid hospitalisation, then there is no doubt that you should be taking the vaccines.

Pavitra: What are your observations regarding the rising number of patients complaining of heart-related issues?

Dr Limaye: A sizeable number of celebrities in their 30s and 40s have been having acute heart attacks, and many of them have succumbed to it as well. In India, we have been witnessing a rise in the number of young people who do not have the traditional risk factors that we usually ascribe to heart disease, like diabetes, hypertension, cigarette smoking and the like. So, it is a little surprising that seemingly healthy people seem to be having these heart attacks, particularly when they go to the gym or are involved in some kind of exertional activity.

I have thought about this as much as other people have, and I don’t think that there is an easy explanation for this. As far as South Asians are concerned, it is quite well known that we are prone to heart diseases. Part of it is genetically determined, and part is attributed to our diet and lifestyle. Particularly, even when there are vegetarians in our country, their diet is rich in processed foods or foods rich in calorie-rich carbohydrates, or their diet is rich in cholesterol, oils and fats.

Pavitra: What is the exact cause of the recent spate of increased condition of heart-related ailments?

Dr Limaye: I think individuals need to be aware of the lifestyle interventions they should do. They must do periodic blood tests to check their cholesterol levels, diabetes signs and high blood pressure to see if they have any of these predilections for heart diseases. The screening is very important because, for instance, diabetes is a silent disease. Many times you don’t even know that you have high sugar. So, the classic signs of increased thirst and increased urination are not present in everybody. Unless you test, you don’t know. So, testing is important.

Pavitra: How do climatic conditions and weather variations affect people differently in the Northern part of India compared to the South?

Dr Limaye: There has been a spate of studies that have attributed pollution as a risk factor for heart disease, and the incidence of heart disease will correlate with the incidence of pollutants in the atmosphere. Delhi NCR region in the winter months sees a high density of air pollution, and therefore, the incidences of heart diseases will be more in highly polluted areas as opposed to lesser polluted areas.

Pavitra: What are the symptoms we should be looking out for so that we can take suitable precautions?

Dr Limaye: The most important symptoms are chest discomfort, particularly on exertion. If you are used to walking a 30 min walk at a particular pace. And one day you find that you are quickly getting tired and you are unable to finish the fourth round of the small garden that you are used to walking in. And you also find that you are having chest pressure or chest congestion earlier than usual, then that is a warning sign that you must see your doctor and get your stress test and ECG done to determine if this is a simple case of heartburn, acid reflux, or a more concerning condition.

Pavitra: What should the local governments do to spread awareness?

Dr Limaye: There continues to be a lot of efforts in the public health arena in terms of trying to educate people to have a healthy diet. Exercise 30 to 45 minutes for at least five days a week. But human nature is reluctant. Even though education may be there, the willpower to execute is not there. I think all of us need to be conscious and need to take out that time and I advise people, particularly workers who work in factories or executives, to take out time during their lunch break or maybe they can walk the last stop of their bus stop. You have to find a way to fit the workout routine into your existing lifestyle rather than having the luxury of going to a gym or spending an hour in the public garden or a garden in your society. We should also be conscious of the denominator, which is the total number of people who are exercising or are involved in physical activity. The number of people who are getting into trouble is minuscule. So, exercise is not bad. Don’t get the wrong message. Exercising is the right thing to do, but you need to be smart about it. If you want to do high-intensity workouts or if you have any symptoms, you must see a doctor or maybe get a stress test done before embarking on those activities.