Health experts know COVID-19 is capable of aggravating existing heart conditions and also cause new ones. The damage can be serious and long-lasting.
As providers learn more about the coronavirus, the potential for it to affect the heart remains an area of significant focus.
Stephen Boateng, D.O., is a noninvasive cardiologist at Sanford Health Bismarck who has been on the front lines in addressing the health care needs of heart patients, some of whom have had those needs complicated by COVID-19.
“We are seeing more patients with heart issues since the pandemic arrived,” Dr. Boateng said. “The pandemic itself has caused quite a bit of stress, and stress can cause heart attacks. For those who have been infected with COVID, there can be some residual and lasting effects on the heart as well, especially if you already have some underlying heart conditions.”
As scientists have learned, COVID-19 can be difficult to track because some people have no symptoms and some have only mild to moderate symptoms. About 20% develop pneumonia and about 5% develop symptoms where the infection elicits an anti-inflammatory response that is out of proportion with the initial infection.
“The body essentially goes haywire,” Dr. Boateng explained. “The immune response does more damage to the body than it should.”
The heart and its three parts
As Dr. Boateng explains, the heart has three parts. The roles of all three parts can be affected by the presence of COVID-19.
- Electrical. “COVID, like all infections, can cause high fevers. The inflammatory, or cytokine response causes the heart to be faster to try to deal with the response. The electrical part of the heart is revved up and your heart starts to beat faster. That alone can cause some strain on the heart.”
- Structural. “COVID can cause heart failure by a direct infection of the heart muscles called myocarditis. It can also lead to heart attacks by causing the heart muscles to work harder. COVID can also cause pneumonia which causes your oxygen levels to drop. When your oxygen levels drop, your heart — which is a muscle and needs blood supply — does not get enough blood for the work it has to do in response to the infection. It’s working really hard and it’s demanding more oxygen and blood, but at the same time you have pneumonia that is causing less oxygen. Then your heart can develop a heart attack.”
- Arteries around the heart. “COVID can tend for you to form clots in the arteries that supply blood to the heart. That can cause a traditional heart attack that causes damage to the heart muscles.”
Keep wearing that mask
As COVID-19 persists, health experts continue to study the potential for long-term effects on the heart. The numbers suggest those effects can linger well beyond when symptoms recede. In one study, which involved giving MRIs to patients who had the virus months earlier, about 78% revealed inflammation and fibrosis in their hearts. Most of them were clinically healthy.
In less than 5%, the MRI revealed patient had severe conditions. Among those problems were heart failure, known blockages or abnormal rhythms such as atrial fibrillation.
“I think overall people with underlying heart conditions should take steps to avoid getting COVID,” Dr. Boateng said. “For the vaccine, priorities are being given to people who are 75 or older and those who have two or more underlying health conditions, including heart disease.”
While much of the world waits to receive vaccinations, the best way to avoid COVID-19-related heart conditions in the meantime is to avoid COVID-19 itself.
“If you have known heart issues and you fit the age group for which the vaccine is being offered now, we recommend that you get vaccinated,” Dr. Boateng said. “We recommend that everyone else do their part to wear a mask, practice good hygiene and social distancing to avoid exposing yourself and others in your family who may be more susceptible to (severe illness with) the infection.”
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