Young hearts at risk: Post-Covid inflammation behind rise in cases

Chennai: A six-year study from Chennai shows that acute coronary syndrome (ACS), a sudden blockage in the heart's blood flow that can lead to an attack, is rising sharply among adults as young as 18. Reason: Post-Covid inflammation, poor lifestyle habits and stress.The study, conducted by a team of cardiologists at Tamil Nadu Govt Multi Super Speciality Hospital, was carried out from Jan 2018 to Dec 2023 and published last month in the European Heart Journal.Of the 10,842 patients studied with ACS, about 70% were from Chennai, and 2,457 were aged 18 to 45. Young men accounted for 74.6% of cases, while women made up 24.4%. "The reason there are fewer cases among women is because of estrogenic protection until menopause. But that doesn't mean they aren't at risk," said Dr Cecily Mary Majella, the cardiologist who led the study.Before Covid, cases among young people rose from 315 in 2018 to 380 in 2019. Post-Covid, the numbers jumped to 480 in 2021 and 564 in 2022. "There was a slight dip in 2020, with just around 200 cases, due to low reporting during the pandemic. Another limitation was excluding pregnant women from our survey," Dr Majella noted.S Satish, a researcher who was also part of the study, said the reason for the post-Covid surge was because "the virus triggers inflammation in the heart's blood vessels and increases the risk of clots. It enters the heart and lungs through special entry points called ACE2 receptors, which is why these two organs are most affected".Cardiologists say the trend continues in 2025, with inflammation of heart muscles not just from the virus, but also from recurring stress caused by work and academics, apart from a poor lifestyle. "WHO guidelines suggest at least two-and-a-half hours of moderate-intensity walking per week, or one-and-a-half hours of high-intensity walking during the same duration for adults. Walking at a normal pace, which is what many who come to the hospital do, alone cannot suffice," said cardiologist Dr Refai Showkathali from Apollo Hospital, Greams Road.Poor lifestyle can accelerate ACS. "Many young people with 40% blockages see them worsen due to smoking and alcohol use, while older people with 70% blockages often remain stable with minimal medication, likely due to healthier lifestyles," said Dr S Murugan, head of the department of cardiology at Stanley Govt Medical College Hospital.Tackling the issue needs to start with prevention and early intervention, say doctors. "Schools should urge teachers not to replace physical education periods with regular classes. This would ensure consistent physical activity, reducing stress and potentially inflammation among students," said Dr Majella.Doctors say they can develop risk-stratification models. "If we suspect a problem, or the young person consistently reports chest pain, an ECG or an ECHO would be a good place to start," she added.

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