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complications following COVID-19 infection; a If you are suffering with unexplained pain or discomfort
comprehensive assessment should be your primary port you might be referred for a chest x-ray with an ECG. In
of call. The optimal timing of post-COVID-19 evaluations extreme cases where abnormalities are detected and/or
depends on the severity of the illness suffered, current symptoms are present further cardiac tests, such as an
symptoms, age, co-morbid risk factors, and resource echocardiography (real time moving pictures of the
availability. Your comprehensive medical history and heart) or Holter monitoring (24-hour ECG) might be
history of COVID-19 illness should form the basis of a requested – these are specialised tests done mostly by
post-COVID evaluation. a cardiologist.
Let's focus on you, the patient who suffered Dizziness, decreased blood pressure, and fainting may
asymptomatic, mild, acute and hopefully non- also be related to abnormalities of the heart post-COVID
hospitalised COVID and the suggested screening to infection. This could be caused by an elevated heart
determine the safe return to activities of daily living, rate or abnormal blood pressure. A blood pressure
exercise, and sport. reading should be a standard screening with any
healthcare consult.
At the heart of it (Cardiac testing)
The common belief is that small cardiac related
Cardiomyopathy (disease of the heart muscle) or disorders following COVID-19 will resolve with time and
myocarditis (an inflammatory disorder of the heart) accurate, graded return or management of physical
appears to be the greatest reported danger to the heart activity and heart rate. Conservative management of
post-COVID. A supervised or graded return to sport can exercise, the use of compression socks, hydration
reduce your risk of a cardiovascular disorder or management, physical therapy, and in extreme cases
permanent damage to the heart muscle. medications prescribed by your doctor, all contribute
toward a safe cardiac recovery.
The minimum risk screening for heart damage is a
resting ECG, and then a stress ECG. Your local general Take a breath (Lung function testing)
practitioner (GP) or Biokineticist can do an ECG
regardless of symptoms present. A standard 12-lead Pulmonary embolisms (blood clot in the lung),
(don't expect to see more than 10 cables/electrodes permanent scarring of the lung tissue and infections/
though) ECG can be used to determine changes or scarring in the lungs have been reported by thousands
abnormalities in the electrical functioning of the heart. of patients recovering from COVID-19.
An abnormal ECG indicates either damage/risk to the
heart muscle or the neural branches of the heart. This If you are not experiencing breathing symptoms (or
would interfere with the electrical pathways required to experiencing mild symptoms), the need for special
make your heartbeat normally. pulmonary function tests (PFTs) should be
unnecessary, a pulse oximeter can be used to
determine oxygen saturation (SpO2). Pulse oximeters Talk of the town is that you will develop a pulmonary
are widely available online and at chemists, and most embolism or a blood clot elsewhere after having covid…
can be used to monitor your heart rate. The normal wrong!! While COVID-19 might demonstrate blood
value for an SpO2 should be greater than 95% oxygen clotting risk (in laboratory blood testing) during your
saturation. infection; the duration of this risk is clinically unknown
and should be managed case-to-case in the recovery
Should your pulse oximetry consistently be below 95% phase. The risk of deep venous thromboses (DVT),
and you have persistent, or new shortness of breath or pulmonary embolism, or arterial thromboses (blood clot
shallow breathing; a full computer-based spirometry in an artery) is present during the symptomatic stage of
(lung function) should be performed to determine your the illness but there is no evidence of the duration of
exact lung volume and functioning (according to height, this risk. Blood testing, such as D-Dimers might be
weight, gender, and cultural group (yip, we all have indicated if unexplained breathlessness is still present
norms)). A computer-based spirometry test will after 10-days of infection. Your doctor might prescribe
determine your maximal exhalation and maximal an anticoagulant medication or a blood thinner if this
inhalation for the management of any neuromuscular risk is still indicated by laboratory-based testing.
weakness and/or lung damage and exercise
prescription (for lung rehabilitation). If access to
computer-based testing is an issue – a simple peak flow I'm just tired of being tired
meter could assist your healthcare provider in
determining of your lung function norms. By far the most common lingering effect you will
experience from COVID-19 is fatigue. This fatigue has
Whilst decreased lung function has been proven to many causes including oxygen and sleep deprivation,
improve over time (with the application of correct cardiac function, lung function and psychology. You
breathing exercises, “breathlessness should undergo a full (physical) functional analysis post-
management”/deep breathing and a full body stretching infection and be monitored throughout recovery until
programme) this is likely to be a slow process. Your return to normal activities of daily living is achieved
lung function should have been managed from day one (feeding, dressing, bathing, toilet runs, driving,
of COVID-19 infection and should continue until it housekeeping, return to work, grocery shopping and
returns to normal. The use of non-steroidal anti- even sporting activities). An assessment of the loss of
inflammatory and bronchodilator type drugs might be function and level of assistance required for activities of
suggested to improve lung function but should only be daily living will guide your rehabilitation plan.
done so under the supervision of your treating doctor. A supervised six-minute walk test (which could form part
of your ECG stress and a lung function screening)
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