How Covid Affects Cardiac Health

As researchers continue to study the effects of COVID-19 on survivors, they are learning more about the way the virus affects heart health. In some situations, the COVID heart health connection becomes apparent while people are hospitalized with the virus. For others, heart problems arise as they recover from the illness.

Heart Monitor

Inflammation from COVID-19

When people catch COVID-19, the body reacts by developing inflammation, which is a normal reaction when the body responds to a virus. Inflammation can affect the heart, resulting in abnormal ECG rhythms or heart rhythms.

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These abnormalities can reduce the heart’s ability to pump and move blood and oxygen through the body. This problem affects adults and children. As COVID-19 is still a novel virus, researchers are still exploring how long the abnormalities affect the body. They are seeing that COVID-related inflammation can result in the formation of clots.

When the heart becomes inflamed, it can send inflammatory proteins called cytokines into the bloodstream. The heart can also become inflamed as a result of the proteins in the bloodstream. Cytokines that cause or respond to inflammation help regulate the body’s response.

If the problems become exacerbated, people with COVID heart health problems can have an arrhythmia, which can result in sudden death.

The inflammation can also come from the endothelial cells that line the blood vessels. When these cells are damaged, blood flow to the heart is compromised. Endothelial cells line all of the blood vessels, from the largest to the smallest, so the problem can become serious very quickly.

Vascular Lining Problems

COVID-19 doesn’t just harm the heart, it also can inflame the vascular system. The problems can cause blood clots to form in blood vessels in the heart and lungs. When inflammation happens in the heart and lungs, less oxygen gets to vital organs.

With vascular problems, the risk of heart attacks and strokes increases, especially with COVID-19 patients. When the vascular system restricts blood flow, the heart has to work harder to move blood to the lungs, especially on the right side. The additional work can cause the right side of the heart to become enlarged. Legs can swell, and the liver and kidneys can fail.

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Long-term COVID Heart Health

While the COVID-19 virus has been around since 2019, researchers are learning more about the long-term effects of the virus, especially on the heart. Some patients who have had myocarditis (heart inflammation) have had some heart cells die and scar. These cells will not fix themselves, and the long-term damage can cause more heart problems.

Researchers will continue to follow people who have had heart problems as a result of COVID-19 to see how these problems affect them many years after contracting the virus.

Heart Problems in High-Risk Patients

People who already have heart problems, then catch COVID-19 are at a higher risk of death due to the virus. People who have pre-existing conditions like diabetes, coronary artery disease, or obesity struggle with the virus creating inflammation and clots.

Since the virus causes other problems like low oxygen levels and low blood pressure, complications from pre-existing cardiovascular conditions can be severe and deadly. The elderly and high-risk patients who caught COVID-19 early on died, which is why the vaccine was developed with such urgency

Compensating for Increased Oxygen Demand

The COVID-19 virus causes fever and infection, which can force the heart rate to speed up. When the heart has to work harder to get blood and oxygen to the body, it becomes stressed. The stress increases when patients develop pneumonia as a result of COVID-19.

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These problems can result in blood pressure dropping which can permanently damage the heart muscle. If the heart is already damaged, the problem can become worse as clots occur and block oxygen from reaching the heart muscle.

COVID-19 heart inflammation can increase the problem as it damages the lining of the blood vessels and speeds up the formation of clots. These clots then cut off the supply of oxygen to the heart. It can also create blood clots in the lungs, further lowering blood oxygen levels. Throw in pneumonia, and the oxygen demand becomes extreme, putting more pressure on the heart.

No Pre-Existing Conditions

People with mild COVID and no pre-existing conditions can also have heart problems. A study conducted by the University of Frankfort found that of 100 people who had no pre-existing conditions before contracting COVID-19, 60 had myocarditis. Their heart inflammation was present two to three months after no longer having the virus.

They also had high levels of troponin, a protein found in people with heart injuries. Of the 100 people in the study, over 70% had elevated protein levels.

Several more studies have found that people who have had COVID-19 end up with heart problems like left ventricular dysfunction and arrhythmia. Of the people with these problems, most only had a mild version of COVID-19, and most did not have pre-existing conditions. They also had a mean age of 49.

COVID-19 Causes Inflammation Throughout the Body

The heart muscle isn’t the only part of the body that experiences inflammation as a result of COVID-19. White blood cells try to protect the part of the body that the virus attacks. As the white blood cells work to protect the body, the areas they protect become inflamed. The inflammation can be long-term or short-term, and it can cause more diseases and problems.

As inflammation moves through the body, it can get into the heart. Once the inflammation reaches the heart, the heart’s function changes. Inflammation causes the heart to develop arrhythmias, where the pumping loses its natural rhythm. Inflammation can also cause the body to release cytokines, which increases the development of blood clots to fight the virus.

When the body develops lung inflammation, the right side of the heart becomes strained. Both the lungs and heart can be permanently damaged when this happens. COVID-19 can also infect the heart, creating significant problems in the heart muscle cells.

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COVID-19 Stress Creates Heart Problems

Heart problems can be a result of people suffering from fear or stress due to the pandemic. Cardiomyopathy, or broken heart syndrome, can cause people to have unexpected heart attacks.

These heart problems can also come from people who avoid getting medical treatment because of their fear of catching COVID-19 at hospitals, clinics, and doctor’s offices. In the earliest stages of the pandemic, people stayed home, even if they were suffering from heart attacks. They avoided hospitals from the worry they would be exposed to the virus.

Anyone suffering from shortness of breath, chest pain, dizziness, or an irregular heartbeat should contact their doctors immediately.

Protecting the Heart By Easing Into Activities

People who have had COVID-19 should not rush back into their physical activity routines. It is best to talk to your doctor before you start exercising again after having COVID-19 because the inflammation can escalate. Myocarditis can stick around for several months after COVID, and your physician can help you understand when you can safely return to exercising.

Long Covid and Heart Problems

Researchers are seeing between 10% and 30% of COVID sufferers developing a problem called “Long Covid.” In one study, long COVID sufferers have common cardiovascular problems that include an increased heart rate, bulging veins, chest pain, and fainting. They also report heart palpitations.

People who caught COVID early in the pandemic report long COVID problems that have lasted at least eight months. Studies also show that people who caught the Delta variant have had more complicated and severe heart problems. The Delta variant has caused more problems for younger people who did not get vaccinated.

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The Vaccine and Connections to Heart Problems

People who are hesitant to get the mRNA vaccine from Moderna or Pfizer worry that it will cause heart problems. Rarely, some people who have received the vaccine have had side effects that include heart inflammation. However, the inflammation is temporary and minor. People who get COVID-19 are at more risk of developing long-term heart inflammation.

Because of the danger of heart problems as a result of COVID-19, physicians continue to recommend the vaccine.

Recognizing Heart Problems After COVID-19

After recovering from COVID-19, it is common for people to report severe fatigue, shortness of breath, and chest pains. These problems could be connected to a potential heart problem, but they could also be from spending time in the hospital or being confined to a bed at home.

Some people have a post-COVID problem called POTS, which seems like a heart problem, but is actually a neurological problem. It affects the heart rate and blood flow by causing people to have brain fog, fatigue, and lightheadedness. If the problem doesn’t go away, you should talk to your doctor.

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Conclusion

Researchers are continuing to study the short-term and long-term effects of COVID-19. With more variants arising, the way the virus affects the body will continue to change. People with pre-existing heart conditions continue to have problems when they get COVID-19, but the virus is also continuing to create new heart problems in people without pre-existing conditions.

References

Heart Problems after COVID-19

Outcomes of Cardiovascular Magnetic Resonance Imaging in Patients Recently Recovered From Coronavirus Disease 2019 (COVID-19)