David G.! We first talk with you, not sitting face-to-face and remotely, as expected in the current environment. That is the reality. What do you think about the epidemic and taken in connection with the measures?
David Ioseliani: the Situation is not pleasant. I would say force majeure. At first it seemed that this plague (roughly, but no other word!) will be able to cope for a couple of months. However, the enemy was insidious and tenacious. Therefore it is necessary to pay special attention to safety precautions, try to reduce the number of contacts between people and thus help physicians who are experiencing enormous loads.
I take this opportunity to pay tribute to colleagues who work on the front line, we can say, in the line of fire, and are at great risk. Every day I learn the names of the doctors who became victims of the new coronavirus. Eternal memory and eternal gratitude!
what’s happening in your field of medicine? Is there any data on the effects of coronavirus on the cardiovascular system? If he can get to the heart, and then what happens?
David Ioseliani: the Problem is serious. Patients with cardiovascular disease, as well as other “Chronicles” are included in the risk group. What does it mean? This means that, in the case of infection with coronavirus, the presence of serious concomitant disease can significantly aggravate the course COVID-19. The body, weakened by existing disease, harder to resist, harder to resist infection. Besides this infection “launches” in the body of certain pathological processes that cause complications of the underlying disease.
What can I say about the connection between “crown” and diseases of the cardiovascular system? See, the thing is new. Still no cardio, maybe thank God, and maybe, unfortunately, not dealt with coronavirus and could not make conclusions about its effect on the heart and blood vessels. But now, literally every day there are new evidence, new information from countries that have already passed crisis peak of the epidemic, and where doctors have had the opportunity to move away from intensive care beds can analyze and summarize the accumulated observations and to draw some, albeit tentative conclusions.
for Example?
David Ioseliani: for Example, has already accumulated is sufficient evidence that coronavirus infection contributes to blood clots and has almost all organs. Not only easy as it first seemed. The body is fighting a pathogen, it releases special factors that increase blood clotting. What does this mean? This means that it increases the risk of thrombosis, that is, blockage of blood vessels, and, consequently, they areno, circulatory disorders of various organs. The danger for any organ – the lungs, kidneys, legs, arms, abdominal organs and, worst of all, brain and heart. If disturbed blood flow to the brain, it can lead to stroke. And impaired blood supply to the heart causes a heart attack.
Complications of this kind threatened only the elderly or sick?.. We constantly hear that the high risk people from the group 65+.
David Ioseliani: Alas, no. I have read reports of American colleagues. According to them, the strokes of the brain develop in patients COVID-19 of varying ages. Very often young, ranging in age from 30 to 50 years. They have the disease itself is relatively easy-sometimes asymptomatic. They had not come to consult about the condition of their vessels. But in the US noted a sharp increase in the number of strokes, moreover, the sudden stroke in this age group. About seven times compared to the normal value.
as for the heart, it is already quite a lot of publications, which clearly States: coronavirus most adverse effect on the heart muscle, i.e. the myocardium. Signs of myocardial damage detected in about 20 percent of patients undergoing treatment for coronavirus. I think that our colleagues working with covenyi patients daily satisfied.
So, we need to check patients for any such damage?
David Ioseliani: of Course, it would be very good and right. But why are you talking only about patients COVID-19? I would like to mention here some important point: all chronic patients, despite the epidemic, should receive the treatment they need, pass all the required examinations in any situation, regardless of any circumstances. Any disease is better and easier to treat non-acute.
There are, of course, of the disease, with treatment which may be some wait, they don’t give a formidable and severe complications. Although it is not really fair. But this does not apply oncological diseases, diseases of the heart and blood vessels. They should be treated according to the schedule, on schedule. It is very important not to break out of this schedule during the period when the viral infection may complicate the disease.
That is the work of the doctors of your speciality – you are engaged in the treatment of acute heart attacks and strokes – increased?
David Ioseliani: We could do more. First, I want to note that, in my opinion, maybe it makes sense to strengthen cardiac care by leading experts in the field in clinics focused on the treatment of patients with coronavirus. I have already said that cardiologists are present. But often or not enough, or they do not work in their major field of study, and as General practitioners. And somewhere cardiologists not at all.
Cardiologists high qualification could establish a cardiology consultation. And this is very important from the point of view of prevention of the most threatening consequences. Secondly, “cores” often do not seek treatment because they fear to get to the hospital, where they believe the risk of catching the virus. But there is also a clinic, as I mentioned in the beginning of the conversation, redesigned and exclusively COVID-19. Suffice it to say that a coronavirus given to the Cardiac center, one of the buildings of the Center named after Bakulev… besides, as I know from press reports that some clinics are not as active as I would like, to respond to the complaints about other diseases, except COVID-19.
I understand, what a huge burden was placed now on the whole health system of the country. Came to us in great trouble, and it is necessary to fight in the first place. But it is unacceptable to ignore the interests of other patients! People are confused, they don’t know where to turn. I think in this situation, healthcare managers, and the media needs to pay more attention, if I may say so, to educate everyone to know what medical institutions continue to operate in its main profile, which can be accessed from a particular disease. Unfortunately, hospitals do not always cope with these challenges. In this regard, I wish to say that the Center of interventional cardiology is in normal mode. We provide a variety of interventions on the heart and blood vessels. We bring to patients by ambulance. Please contact us, we are ready to help our profile patients!
David G. and are there any specific features in the treatment of heart and vessels against a coronavirus infection?
David Ioseliani: In the present situation we have to learn “just in time”. In the world have a number of guidelines and recommendations for surgical and endovascular treatment of patients with cardiovascular diseases, occurring against the background COVID-19. We are studying these recommendations and seek to complement and develop them on the basis of their own observations. The more patients will be in our hands, the more we can benefit – and that patients and those who come after them. I have to Express my admiration for my colleagues who perform the most complex procedures in patients with COVID. This is a unique experience in providing specialized cardiac care to patients with this highly contagious infection. I think this experience will be useful to professionals of all countries with a high prevalence of this virus.
it seems to Me that the current situation will serve as an important lesson and an important PReupresident that the whole world should unite in the fight against this evil. Only together, regardless of nationality, religion, political beliefs, etc., we will be able to defeat evil and to save our fragile world.
