Pandemic conditions are not going away soon. The same can be said in some cases for the effects on the heart during and after a bout with the coronavirus.
The ramifications can be significant and there is still much to be learned.
“So what we’re dealing with then is the aftermath. We really don’t even know how long these chronic symptoms will last. We have only been following this for several months.”
Dr. Nayan Desai, who specializes in interventional cardiology at Sanford Heart Bismarck, has been caring for patients dealing with coronavirus-related heart problems.
In time, researchers would like to be able to anticipate who is at risk of dealing with lingering symptoms. They also want to gain insight into whether treatments in the early stages of COVID-19 might minimize the duration and severity of heart problems caused by the virus.
For now, the work continues.
Lingering heart effects
“We know that the virus directly and indirectly affects the heart and has consequences leading to cardiac injury,” Dr. Desai said. “Long-term data is still coming out about the virus and its effect on the heart.”
It is why COVID-19 patients admitted to the hospital get a 12-lead EKG. It establishes a baseline for a possible heart injury.
“I like to think of it like this: How does the virus affect the heart?” Dr. Desai said. “Does it affect the heart’s electrical system? Is it affecting the thumping of the heart? Or the plumbing? Is it causing clotting? Does it increase the threat of heart attack in patients?”
Most common among COVID-19 patients is myocarditis, an inflammation of the heart tissue usually caused by a viral infection.
“It can represent a wide spectrum of conditions for the patient,” Dr. Desai said. “In some people there might be very mild manifestations. In others it can have long-term consequences that can include heart failure due to weak heart muscle which can lead to congestive heart failure and arrhythmias.”
In many cases, these issues affect those who are already susceptible to heart conditions. For instance, as people age they’re more likely to deal with atrial fibrillation, a form of arrhythmia (irregular heartbeat) involving the upper chambers of the heart.
“Identifying it is important either before, during or after admission to the hospital,” Dr. Desai said. “It is important even after the patient has recovered from COVID-19. If the heart muscle does not recover, we’re looking at serious problems.”
Young people also affected
Though older people with underlying illness are most susceptible to heart damage from the virus, younger people with COVID-19 can also suffer from myocarditis.
Severe heart damage has occurred in young, healthy people, but is rare. The CDC reports significance of long-term mild effects are unknown.
Of concern recently is that some people who take heart medications commonly used to treat congestive heart failure and high blood pressure are deciding not to take them because of the false belief these medications can make a COVID-19 infection worse.
“Time and time again it has been shown that this is not true,” Dr. Desai said. “It is important for patients to continue with their heart medications. If you stop these medicines, the heart muscles can become weak or the blood pressure can rise enough to cause potential damage.”
Pandemic conditions add stress
COVID-19 factors in heart health can go beyond the purely physical. Pandemic conditions come with potential social, psychological and economic consequences that have increased the occurrence of “stress heart,” also known as “broken heart.” It’s a condition that causes the bottom part of the heart to stop working.
“In some cases it can predispose to patients going into shock dealing with arrhythmia,” Dr. Desai said. “These are people who don’t have COVID but are dealing with the stress of living through the pandemic.”
It is important, then, to maintain your mental health hygiene and maintain a heart-healthy diet.
“Now that things are returning to more normalcy, people should start going back to the gym,” Dr. Desai said. “Or go for a walk. Exercise however you can while maintain social distancing.”
Above all, it is important to get the right information regarding possible effects. Take your questions to your heart doctor. And understand that progress is being made in coronavirus-related issues of the heart.
“It’s easy to say ‘Be patient, this will get better,” Dr. Hoffman said. “That’s a very difficult thing to do. What patients need are significant family support. They need support from the health care system. They need a good thorough evaluation to make sure everything is going okay. Time will improve things. The patients that I have seen are getting better, albeit slowly. And so there is hope at the end of the tunnel.”
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