>>>
>>> PRESIDENT TRUMP HAS BEEN PITCHING THE BENEFITS OF
HYDROXYCHLOROQUINE IN THE FIGHT
AGAINST COVID-19 BUT A NEW
STATEMENT OF CAUTION CAME OUT
YESTERDAY FROM THE LEADING HEART
EXPERTS IN THE COUNTRY, WARNING
AGAINST THE USE OF DRUGS LIKE
HYDROXYCHLOROQUINE, IN THIS CASE
TALKING ABOUT POTENTIALLY FATAL
CARDIAC EFFECTS.
CARDIAC EFFECTS. LET'S DISCUSS THE FINDINGS.
WHAT
WHAT
WHAT IS
WHAT IS IT WE LEARNED FROM THIS GROUP
OF CARDIOLOGISTS AS FAR AS THEIR
CONCERNS ABOUT THESE
MEDICATIONS?
MEDICATIONS? >> SO BOTH THESE MEDICATIONS,
HYDROXYCHLOROQUINE AND
HYDROXYCHLOROQUINE AND AZITHROMYCIN CAN CAUSE AN
ELECTRICAL DISTURBANCE IN THE
HEART THAT TAKES TOO LONG FOR
THE ELECTRICITY TO RESET THE
HEART BEFORE THE NEXT HEARTBEAT
AND THE PROBLEM WITH THIS
CONDITION IS THAT IT CAN QUICKLY
DEGENERATE INTO A LIFE
THREATENING ARRHYTHMIA OR RHYTHM
DISTURBANCE.
DISTURBANCE. SO WHAT WE'RE TALKING ABOUT HERE
IS YOUNG HEALTHY PEOPLE
POTENTIALLY WHO ARE TAKING THIS
MEDICATION AND CAN DEVELOP THESE
LIFE-THREATENING ARRHYTHMIAS
LIFE-THREATENING ARRHYTHMIAS THAT CAN CAUSE THE HEART TO STOP
AND HAVE SUDDEN CARDIAC ARREST.
CERTAINLY IF YOU'RE OLDER OR
HAVE CHRONIC HEALTH PROBLEMS OR
ARE IN THE ICU, YOUR RISK OF
HAVING QT PROLONGATION IS MUCH
HIGHER.
HIGHER.
HIGHER. OFTEN WE SEE IT IN YOUNG HEALTHY
PEOPLE, PARTICULARLY IN WOMEN.
WHEN THE WHITE HOUSE IS TELLING
US THAT THERE'S NO HARM IN
TAKING THIS COMBINATION OF
MEDICATIONS, THE HEALTH EXPERTS
WANT EVERYBODY TO KNOW THERE IS
HARM AND POTENTIALLY
LIFE-THREATENING FATAL
LIFE-THREATENING FATAL COMPLICATIONS THAT CAN OCCUR
FROM TAKING THIS COMBINATION OF
MEDICATIONS SO WE SHOULDN'T TAKE
IT UNLESS THERE'S DEFINITELY A
PROVEN BENEFIT.
PROVEN BENEFIT. >> AS WE'VE LEARNED ABOUT
HYDROXYCHLOROQUINE, PEOPLE WITH
LUPUS AND RHEUMATOID ARTHRITIS
TAKE IT.
TAKE IT.
TAKE IT. DO THEY RUN THAT SAME RISK AS
FAR AS THAT SORT OF ARRHYTHMIA?
>> VERY IMPORTANT QUESTION.
THE RISK REALLY COMES IN THE
FIRST FEW DAYS OF TAKING THE
MEDICATION.
MEDICATION. SO WHEN YOU START THE
MEDICATION, AS YOU'RE GETTING
MORE AND MORE DOSES, IT'S REALLY
IMPORTANT TO MONITOR YOUR QT
WHICH IS DONE WITH THE EKG OR
ELECTROCARDIOGRAM.
ELECTROCARDIOGRAM. FOR MOST PEOPLE ON IT
CHRONICALLY, THE QT IS NOT GOING
TO CHANGE TOO MUCH BECAUSE THEIR
BODY HAS COME TO A STEADY STATE
AND IS SORT OF AT PEACE WITH THE
MEDICATION.
MEDICATION. BUT WHEN YOU'RE STARTING THE
MEDICATION OR GIVING IT FOR THE
FIRST TIME, THAT'S WHEN YOU CAN
REALLY HAVE THOSE RISKS OF
COMPLICATIONS.
COMPLICATIONS. >> WE TALK ABOUT COVID-19 AS A
LUNG VIRUS.
LUNG VIRUS. WHAT DOES IT DO TO THE HEART AS
WELL?
WELL?
WELL? >>
WELL? >> IT'S SO FASCINATING, WE'RE
LEARNING MORE AND MORE ABOUT
THIS VIRUS.
THIS VIRUS. WHAT WE'VE LEARNED RECENTLY IS
THE ACE 2 RECEPTORS, WHICH THE
VIRUS USES TO GET INTO THE LUNGS
ARE ALSO PRESENT ON THE HEART
AND THE BLOOD VESSELS SO THAT
MEANS THE VIRUS IS DIRECTLY
GETTING INTO THE HEART CELLS.
FOR SOME PEOPLE, THAT MEANS
DIRECT DAMAGE TO THE HEART
MUSCLE, WHICH CAN MANIFEST AS
HEART ATTACKS OR HEART FAILURE.
FOR OTHER PEOPLE IT JUST MEANS
AS PART OF THE IMMUNE SYSTEM'S
REACTION TO THE VIRUS, THEY CAN
GET DAMAGE TO THE HEART MUSCLE
OR GET ARRHYTHMIAS.
INTERESTINGLY WE'RE SEEING A
SMALL SUP SET OF PATIENTS WILL
PRESENT WITH HEART ATTACK
SYMPTOMS LIKE CHEST PAIN INSTEAD
OF THE FEVER, COUGH, AND
SHORTNESS OF BREATH WE'VE BEEN
TALKING ABOUT SO MUCH.
THIS HAS REALLY HEIGHTENED OUR
AWARENESS THAT THIS IS A
MULTI-SYSTEM VIRUS.
MULTI-SYSTEM VIRUS. IT'S NOT JUST THE LUNGS.
IT CAN AFFECT OTHER SYSTEMS.
WE'VE ALSO FOUND THE PRESENCE OF
THE RECEPTORS ON THE KIDNEYS AND
INTESTINES AS WELL.
>> THESE CARDIAC EFFECTS WE'RE
SEEING FROM COVID-19, ARE THESE
ONLY FOR PATIENT WHOSE HAVE HAD
PRIOR HEART DISEASE?
>> THAT'S THE SCARY PART.
OF COURSE THE RISK IS THE
HIGHEST IN THOSE PATIENTS THAT
HAVE HAD PRIOR HEART DISEASE OF
HAVING THESE CARDIAC
COMPLICATIONS LIKE HEART ATTACKS
OR HEART FAILURE.
WHAT WE'VE FOUND IS 7% OF ALL
COVID PATIENTS HAD EVIDENCE OF
DAMAGE TO THEIR HEART AND 12% OF
THESE, SO MORE THAN 1 IN 10
PEOPLE WHO HAD DAMAGE TO THEIR
HEART WERE PEOPLE THAT NEVER HAD
HEART DISEASE BEFORE AND THAT
CAME AS A REAL SURPRISE.
>> A LOT WE'RE LEARNING.