Episode Transcript
Alan Helgeson (host):Hello and welcome. You’re listening to the Health and Wellness podcast brought to you by Sanford Health. I’m your host Alan Helgeson with Sanford Health News. Our conversation today is about COVID-19 and the long-term effects on the heart. Our guest today isDr. Tom StyswithSanford Heart. Dr. Stys, as we get started today, why don’t you give us a little bit about your role and your background with Sanford Health?
Dr. Tom Stys:I believe it’s almost 20 years since I started at Sanford Health. It was my first job, in fact, after coming out of fellowship training in New York when I remember we came out with my wife, from New York, Long Island. And we came out to South Dakota for the first time ever in January. We did go ahead visit some small towns, USA, South Dakota middle of January, went blowing snow and …
Alan Helgeson (host):Knew you needed a coat.
Dr. Tom Stys:Yes, no question about that. And then, you know, we did see I that that’s, yes, it was an opportunity, opportunity for us to have our family, kids grow up in a Midwestern environment, culture that we very much appreciated, which is awesome. And I personally had an extremely successful career here as an interventional cardiologist, meaning that I found Sanford’s resources, and ambition, completely in pair with mine. We evolved in the Cardiovascular Institute, affiliated ourselves with Sanford School of Medicine, USD. In fact, we hold the chair position for the division of cardiology for USD School of Medicine. Five of our cardiologists are the core faculty. We have introduced anything that was innovative and permissible in the field of interventional cardiology, electrophysiology, and other areas of cardiology and brought it to the region. And I believe I can very confidently say that we have created the leading program in the Dakotas.
Alan Helgeson (host):So now being here 20 years associated and affiliated with Sanford and a big anniversary, a 10-year anniversary for the Sanford Heart hospital. So in that 10 years prior, you had a hand in really helping lay that foundation and what that looks like and building the program, correct, Dr. Stys?
Dr. Tom Stys:这是正确的。这是正确的。我们非常幸运地坐在我们新的心脏医院里。好,10年。也许我不应该用"新"这个词我们现在已经习惯了，但这是一个很漂亮的设施。我记得计划、设计和管理。我记得和来自世界各地的介入性心脏病专家和心脏外科医生一起做手术，说实话，当他们来到这里，看到我们的机构时，我没有遇到过一个人不被打动的。
Alan Helgeson (host):Well, congratulations to you and your team and the program that you’ve built. And we’re talking about something today. There isn’t any part of medicine that over the last year, two years, that has not been touched by COVID-19 or coronavirus, and things that we’ve heard way too much about the last couple of years, and in interventional cardiology, you’re no different. Our topic today, we really wanna talk about the connection between COVID-19 and heart health, as we’re hearing that there are short and long term effects that COVID-19 can have on the heart. Can we just jump in right there and just from your expertise let’s talk about that, Dr. Stys.
Dr. Tom Stys:是的,当然。事实上，最重要的是谈论COVID，以及它如何以许多不同的方式影响心血管疾病患者。事实上，在流感大流行的早期，我们就意识到病人和社区的恐惧是巨大的，这是恰当的。然而，人们对心血管疾病认识不足，对心血管疾病本身的问题认识不足，如果不加以处理，就会得到适当的照顾和治疗。所以从数据上讲，心脏病，心血管疾病，心脏病发作，中风仍然是头号死因，句号。这是去年的情况，那是我们的新冠疫情年。COVID成为第三大死因。
We very quickly learned early in the pandemic that we will have patients that will be failing to come and seek attention. They will be having symptoms, which sometimes I feel patients are a blessing because at least those patients do get early symptoms of heart disease have a warning sign that allows them to identify an issue, seek attention and help, and perhaps prevent a severe disease that otherwise could be growing with, ultimately its consequences, unnoticed until it’s too late.
So very quickly early in the pandemic, we initiated a campaign of advising our patients, not to neglect cardiovascular disease. And I think that’s the first monitoring, which we very quickly recognized that COVID affects cardiovascular disease.
我们的患者最初害怕来寻求治疗，而这种治疗通常可以挽救生命。我们开始看到越来越多的病人患有晚期心脏病，有晚期心脏病发作的情况，这些病人都有心脏病发作的警告信号。我们解决问题。他们第二天回家，突然出现心脏骤停，进入心源性休克。这是一个完全不同的故事。
My colleagues in cardiology, the division at their institutes, we very quickly identified and appropriately addressed where we even worked with departments of health and the state to make sure that we all had the same message. So then there are other ways where there’s no question COVID affected us. And the pure disease of COVID itself includes effects on heart/cardiovascular system.
And so indeed COVID does create circumstances in our body that can lead to increased frequency occurrence of clot formation, increased occurrence of heart attacks, some arrhythmias, inflammation of the heart muscle, and heart failure. So, there is a number of ways that the disease process itself also affects the hearts and results in bad outcomes.
COVID can affect us in many different ways. Too often, we do not link COVID disease syndrome with cardiovascular disease that COVID can cause directly. Not only COVID can affect outcomes of conventional atherosclerotic coronary artery disease, stroke disease syndromes, by, as I mentioned earlier, neglecting to get help, attention in a timely fashion, but also COVID itself affects cardiovascular system and can be a cause of exacerbation in the form of cardiovascular syndromes.
And for instance, yes, we can have an increased incidence of inflammation of heart muscle, myocarditis, heart failure. We can have increased incidence of stroke. We can have increased incidence of arrhythmias. We have a lot of patients that, after they recover from COVID, have long-term symptoms. And, sometimes it’s even tough to say is it’s relating COVID lung disease, it’s related to heart and consequences of the COVID syndrome associated with cardiovascular disease. Sometimes it’s tough to differentiate. Nevertheless, there’s clear association between COVID and cardiovascular disease. So COVID does affect the cardiovascular system directly.
But I believe that it’s, it’s also very important to recognize that COVID will affect our cardiovascular system in different indirect ways and we very well know that cardiovascular disease for instance, is a lifestyle disease. It’s lack of exercise, our extra weight, smoking, poor diet that are responsible perhaps for majority of cardiovascular disease. Interestingly, it’s a very preventable disease with that in mind, because how easy is it to eat less and exercise more and weigh less? Well, it’s easy to say, tough to do nevertheless, at least theoretically, it’s a very, a preventable disease, but it’s tough for us to do.
Now in COVID pandemic, unfortunately with the isolation, with the lack of outdoors activities, with lack of opportunities to socialize, go out and spend time in many diverse ways that would be perhaps healthier from heart’s perspective. Well, we ended up isolating ourselves, not only physically at home but also psychologically, much less interactions with others in the society.
Well, as by not going out for a routine walks to the mall, shopping, theater, movies, restaurants that stripped us from an opportunity that’s extremely important as far as healthy living. Unhealthy lifestyle behaviors that we have actually observed during the pandemic are increasing incidence of bad diet and extra weight, obesity.
I have to say that that just about every other patient comes to see me currently in the clinic, unfortunately when they step on the scale, the weight is in the wrong direction. They gain weight and it is always the same excuse. Well, I don’t go anywhere. I don’t do anything. I sit at home, watch TV. And the only thing to do is grab snack after snack and, which is sad, right? But very true. And that is a way in which COVID affected us last year. That’s not minor.
Another unfortunate, bad habit that we’ve noticed increased, increased incidents is alcohol consumption. You know, alcohol is not heart healthy. And there’s a clear association between the COVID pandemic and increase in the alcohol consumption that then leads to mental issues, more social issues, more problems, and definitely in a less heart healthy lifestyle than otherwise.
错过就医是COVID非常客观地影响我们的另一种方式。当我们研究我们在南达科他州的人群时，你可以说有一个非常非常大的不依从性在其他必要的医疗随访中。你知道，不管你称之为不服从还是，你知道，不了解情况，绝对不是心血管疾病的积极因素。正如我之前提到的，心血管疾病仍然是头号死因。所以如果我害怕感染COVID和死亡。你知道吗，我应该和你一样，甚至更害怕得心脏病。因此，从心血管角度来看，对COVID的恐惧不应该真正阻止我获得关注。
There has been an observed fear of hospitals. So no, I will not go to hospital and I’m not feeling well because that’s where I can get COVID more so than anywhere else. Again, the very false assumption, you know, and we very early in the pandemic made a big effort to make sure that it’s very clearly publicized in media across our state that no, it is probably one of the safest places where everybody’s compliance precautions are taken special, units are organized. And if anything, I think that you should feel safer going to see your doctor or be admitted to hospital for other, perhaps not COVID related issues, then going shopping to a grocery store. So, so it’s very interesting, but that fear of hospital was real. And it did I believe impact outcomes as far as our cardiovascular patients.
因此，正如你所看到的，COVID也从心脏病的角度间接影响了我们的患者。
Alan Helgeson (host):Is age impacting some of those effects that you’re seeing?
Dr. Tom Stys:就COVID的结果而言，年龄无疑是一个非常相关的因素。我们发现老年患者的预后很差。已有心血管疾病的患者预后较差。我们的心血管病人都是老年病人。我们很好地观察到，年轻人群，尤其是青少年，当他们感染COVID时，他们的疾病没有那么严重。这是否与年龄本身或其他共病有关，很难说，但作为一名心脏病学家，我必须说，是的，年龄显然被认为是导致病情恶化和结果恶化的风险。
And at the same time, yes, it is our elderly patients that have more cardiovascular disease, preexisting cardiovascular disease, such as coronary artery disease, hypertension, diabetes, stroke history, those cardiovascular diseases themselves, if preexisting will make COVID disease worse.
Alan Helgeson (host):As a person that has been vaccinated, can you still be affected with heart health and heart issues through COVID even if you’re vaccinated?
Dr. Tom Stys:是的,你可以。然而，已经很清楚地证明，完全接种疫苗的病人患病过程要轻得多住院的可能性也小得多，死亡的可能性也小得多。尽管如此，他们仍然可能受到COVID的影响，并出现急性疾病。这就是我们的建议。即使你已经接种了疫苗，你仍然要小心谨慎。
Alan Helgeson (host):你看到那些已经有心脏问题的人有哪些挥之不去的症状?
Dr. Tom Stys:所以，首先，我想说，正如我之前提到的，你知道，COVID的症状往往很像心脏病。有时很难诚实地告诉患有既往心血管疾病的患者，一旦他们从COVID中恢复，这些症状仍然是COVID遗留的症状，还是这些症状真的更与他们的潜在心血管疾病因COVID恶化有关?So that’s a very challenging issue for us currently.
We see a lot of people coming to get rechecked after they had COVID with one of our cardiologists in the office. And, the reason is that the symptoms are frequently similar. Each time we had a wave of acute infections in the community, a few weeks later, we have a wave of patients who’ve recovered from COVID and coming for cardiovascular checkups. In those instances, we check patients very thoroughly.
我认为这是非常谨慎的彻底，不要错过从COVID恢复的患者的心血管疾病的进展，因为我早些时候说，仍然心血管疾病是头号死因，如果你关心COVID，你应该关注同样多，甚至更多，从心血管疾病的角度。
Alan Helgeson (host):对于可能正在接受心脏病专家治疗的人，或有心脏问题一段时间，可能刚刚从COVID-19中恢复的人，您有什么建议?你有什么具体的事情想对观众说吗?
Dr. Tom Stys:Definitely. It’s a very good and a very important question. Symptoms of COVID frequently mimic symptoms of cardiovascular disease. COVID itself affects cardiovascular system. So not only you could say that in a way it is also a cardiovascular disease, but at the same time, the fact that you have COVID does not mean that nothing else coincidentally might be going on in your body.
So my advice would be to be aware of too easily, assuming that it’s COVID, I don’t need to worry about my cardiovascular health. Have a very low threshold to pick up the phone, call your doctor. There is nothing wrong, even if you’re on isolation, with having a phone conversation with a doctor, cardiologist, especially with preexisting cardiology condition, cardiac conditions. Discuss the symptoms and see if you need to be concerned or not neglecting symptoms that otherwise may be early signs of something bad happening with your heart, may result in your having not only COVID, but also presenting with a heart attack. And then it’s a very challenging situation.
Alan Helgeson (host):What can a person do to help prevent or lessen the possibility of long-term heart effects from COVID-19?
Dr. Tom Stys:I think I would resonate the CDC recommendation of getting vaccinated. That is the best way to, first of all, hopefully avoid the infection and disease altogether, but at the same time avoid the otherwise possibly grave consequences of severe illness and even dying of COVID. So get vaccinated.
Alan Helgeson (host):We’ve talked about, you know, people staying out and not getting routine appointments. Can you just share a little bit from your perspective as a cardiologist, the importance ofheartandvascularscreenings?
Dr. Tom Stys:Getting early attention in the course of cardiovascular disease is lifesaving. As I always say, it’s a very preventable disease, first of all, so you can prevent it altogether. And even if you start getting some atherosclerotic disease, plaques, mild plaques here, or there at that stage, you can still intervene and treat it very effectively where you might not even have any consequences of that plaque formation process throughout your life.
Cardiovascular diseases are very preventable and very treatable. The worst thing to do is not get attention when you’re affected. And that’s exactly where our community cardiovascular disease screening program fits. We have very effective, accurate, simple ways of identifying patients that’s a high risk of developing severe cardiovascular disease, whether it’s heart attack, whether it’s other forms of cardiovascular disease. So we should be using those tools. And that’s our screening program.
Alan Helgeson (host):Dr. Stys, thank you for taking time to join in this conversation about heart health and COVID 19. This episode is part of the Health and Wellness series by Sanford Health. For additional podcast series and topics, please click the podcast link on Sanford Health News. I’m Alan Helgeson. And thank you for listening.
Learn More:
…
Posted InCoronavirus,Expert Q&A,General,Heart,Immunizations,Physicians and APPs,Sioux Falls,Vascular,Wellness
