In Covid times - Don’t take the summer heat to your heart

by Dr Harinder Singh Bedi 

Summer heat and humidity make most of us uncomfortable, but this can be deadly for heart patients. The heart responds to a rise in temperature by pumping faster. Moderate exercise may result in up to tenfold increase in heat production with a resultant rise in heart rate and a risk of a heart attack.
During hot weather, diuretics (water pills to reduce fluid retention in patients with heart failure and high blood pressure) may actually cause dehydration. However, they should be warned against drinking large amounts of fluid  (as recommended to the general public during heat spells), as this could add significant stress on heart .

KEEP YOUR COOL
Overall, individuals with heart disease should follow the same guidelines as healthy individuals, but with an extra helping of precaution:
■ Stay indoors during the hottest part of the day.
■ If your home isn’t air conditioned or air cooled , stay confined to the coolest spot such as the basement.
■ Limit your activity.
■ Wear loose-fitting, light cotton clothing.
■ Stay hydrated and avoid caffeine and alcohol.
■ Have someone check in on you on a regular basis.

LIVE RIGHT, EAT RIGHT
The best advice for avoiding heat stress is to keep as cool as possible. Air conditioning can provide lifesaving relief from heat stress, especially if you have heart disease . If you don’t have air conditioning, spend as much time as possible in cool shopping malls once lockdown is over ( but still avoid groups)  or in the coolest room at home . Indigenous air coolers with khus (vetiver) screens can also be quite effective.
Fans and cross ventilation are important. Cool baths or showers provide relief from the heat.
Loose fitting, lightweight, light coloured cotton clothing are more comfortable in hot weather. While working in Sydney I couldn’t fail to notice the Australian campaign of Slip-Slop-Slap (Slip on a full sleeved loose shirt, slop on some sunscreen (to protect from skin cancer) and slap on a hat). This can be a sensible routine for heart patients to follow too.
Your body needs more water in hot weather Don’t wait until you are thirsty to have water . If you have heart disease check with your doctor for advice on how much water you should drink.
Curtail unnecessary physical activity during extremely hot weather. Avoid spicy hot foods and heavy meals. Watch your salt intake.
Avoid alcohol and caffeine . Alcohol acts as a diuretic, resulting in fast water loss. In addition, alcohol can promote a sense of well-being, making you less aware of the danger signs of heat stress. If you live alone, make sure a relative or neighbour checks in on you regularly even if only on the phone .

However, the summer does not mean the end of exercise. It is  best to plan your exercise early in the morning before the day heats up, or in the evening, when things start to cool down. If the weather is unbearably hot, though, head indoors. Activities as suggested by the American Heart Association include going to an air conditioned gym – but wait till it is safe – corona wise ! . You also could start a walking group with your friends at your local AC mall – (again wait)   – an extremely entertaining form of exercise – as long as you’re not a compulsive shopper ! . Avoid very strenuous exercise with a mask on . 

Take up  indoor yoga  . If you are blessed with even a small personal pool - swimming is the best exercise which also cools !. 

So, enjoy the summer – but stay cool.

The author is Director Cardio Vascular & Thoracic Sciences at the Ivy Hospital Mohali and was earlier at the Escorts Heart Delhi and the St Vincent’s Hospital, Sydney.