Solving doubts of patients with coronary artery disease How should I vaccinate for COVID-19? : PPTVHD36

Many people are worried about the COVID-19 vaccination. Regarding the side effects that may occur in the short and long term Especially patients with chronic diseases such as coronary heart disease are particularly worried. Therefore, understanding correctly and preparing properly before vaccinating against COVID-19 therefore it is important

Cardiovascular disease groups at severe risk if infected with COVID-19

For people with chronic and chronic diseases If infected with COVID-19 There is a very high likelihood of developing a severe disease and an increased chance of death.

Vaccines against COVID-19 Solving doubts, how many injections will be enough?

Found that “COVID-19” patients can have neurological symptoms.

especially among patients with pre-existing cardiovascular disease. for example

1. Patients with acute cardiovascular disease who have been hospitalized in the last 6 months
2. Patients with pulmonary arterial hypertension
3. Congenital heart disease in adults with congestive heart failure
4. Patients with chronic coronary artery disease who still have chest pain.
5. Patients with severe heart failure or heart transplant patients.
6. severely obese patients especially if the BMI is more than 35 kg per square meter.
7. Patients with 2 or more uncontrolled cardiovascular disease risk factors, such as diabetes, high blood pressure, etc.
8. Patients with comorbidities with insulin-dependent diabetes mellitus whose blood sugar levels are poorly controlled.

The advantages of the COVID-19 vaccine with patients with cardiovascular disease

Cardiovascular disease as mentioned above. You should be vaccinated against COVID-19 immediately if your symptoms are under control and your symptoms have calmed down. To make the body immune to COVID-19 Because if you can’t protect yourself and get infected with COVID-19 The body will be able to fight COVID-19 with the following effects:

• If the immunity is high enough, it can kill germs.
• inhibits the division of bacteria in the body prevent the virus from dividing Viruses cannot multiply in the body.
• The virus is unable to enter the cell and therefore does not cause infection. which is well known that If you have a heart disease or coronary heart disease before. The risk of infection is severe enough to require admission to the ICU and the risk of death is higher than those without cardiovascular disease.
• If the virus cannot divide in the body The infection will not be able to spread to other people. This is to prevent and reduce the chances of infecting others.
• If everyone has immunity in the body COVID-19 will no longer be able to grow and reproduce. thus breaking the epidemic cycle and also breaking the mutation cycle of the infection.

Prepare patients with cardiovascular disease before vaccination

Preparation and behavior for patients with cardiovascular disease before vaccination against COVID-19 include:

1. Check the symptoms of the disease that is symptomatic or not. Especially in patients with coronary artery disease, it is important to consider whether life-threatening symptoms are present. For example, patients with acute coronary syndrome will experience angina In particular, chest pain during exertion or exercise in the middle of the chest or ruptures to the left arm, etc., and coronary artery disease symptoms are accompanied by acute heart failure, such as tiredness, inability to lie down, or having to sleep on high pillows. or with pulmonary edema

If all of the symptoms mentioned above It is imperative to heal and get better. However, there is no specific requirement on how long after complete recovery can be vaccinated. Therefore, at the discretion of the physician treating each patient individually, the vaccine may be administered when the patient has stable symptoms and is ready to leave the hospital to return home. or the period when the patient has gone home and follows up on outpatient treatment, is to follow the doctor’s appointment

2. In the case of patients with severe high blood pressure especially if systolic blood pressure is greater than 160 mm Hg. It is essential to keep your blood pressure well controlled before vaccination. The systolic blood pressure must be kept below 140 mm Hg on the day prior to vaccination.

3.In the case of taking Warfarin anticoagulants If INR is consistently stable and INR is less than 4.0 within 1 week, or the previous INR result was consistently below 3.0 (no need to stop or adjust the dose and no need to check INR before getting vaccinated) can get vaccinated against COVID-19 can be obtained using a 25G or 27G small syringe injected into the upper arm muscle Then press on the injection site for about 5 minutes, then may be followed by a cold compress with ice or cold gel.

4. For patients taking new anticoagulants (NOACs) and antiplatelet drugs. such as Aspirin, Clopidogrel, Ticaglelor, or Prasugrel, the vaccine can be administered without stopping the medication before the injection. A small needle 25G or smaller should be used and the muscles should not be stretched after vaccination. Press the injection site for at least 5 minutes and be sure there is no abnormal bleeding.

People who have been vaccinated against COVID-19 both before and after the injection Able to carry out normal daily activities (such as consuming food and beverages, including tea, coffee, various medications, as well as performing normal tasks) and should not exercise harder than usual or less rest than usual in the 1-2 days before and after vaccination

If other vaccines are needed (eg rabies vaccine, Tetanus Vaccine) Get vaccinated against COVID-19. without the need for a period of time but to be injected in different positions In the event that symptoms must be observed and adverse reactions from each vaccine may be spaced approximately 1 week apart

People at risk of coronary heart disease with vaccines

For people at risk of coronary heart disease such as high blood fat. High blood pressure, diabetes, these conditions, if controlled and stable A medical examination is not necessary before vaccinating with COVID-19, but if it is still poorly controlled or uncontrollably, you should consult your doctor for a thorough diagnosis before vaccination. If you are unsure or have any other abnormalities that you think may be related to the underlying disease You should consult your doctor before vaccinating.

Patients who need to treat coronary heart disease with the COVID-19 vaccine

For people who need treatment for coronary artery disease, such as patients who are about to undergo balloon surgery or a stent. or patients who are about to be treated with coronary artery bypass surgery who still show symptoms of coronary artery disease Treatment should be completed before being vaccinated against COVID-19.

However, if the appointment is for coronary angiography or coronary artery bypass surgery in cases where the disease is relatively calm or not showing symptoms, a cardiologist should be consulted to determine in detail the chances of infection. or in the community Or a group of people with a relatively high outbreak? If assessed, the benefits of vaccination are greater, should be vaccinated against COVID-19 first, which depends on the discretion of the doctor and the situation of infection at that time.

Covid-19 vaccine with thrombosis

for the adverse reactions that many people are concerned about But the incidence is quite rare. Especially in the elderly group is the incidence of thrombosis in the blood vessels. which may be found only 1 in a million doses only especially in people who take blood clot-dissolving drugs. anticoagulants and antiplatelet drugs The incidence of venous thrombosis from vaccination was even lower.

Vaccination at a medical facility that is ready

Patients with cardiovascular disease should be vaccinated against COVID-19 in a healthcare facility that is well equipped to observe symptoms. especially 30 minutes after vaccination. in order to be able to provide timely care if there are complications or adverse conditions Most of the adverse events in the first 30 minutes after vaccination were localized symptoms. and mild symptoms such as pain at the injection site; other symptoms such as headache, breathlessness, muscle aches, fever, chills, joint pain or nausea, during which the symptoms were observed If any of these abnormalities are found, notify staff for immediate evaluation. The information that has been studied has found that These symptoms are less common with vaccination in older patients. And it is more common in those who have been vaccinated younger.

Thank you health information from Bangkok Hospital