Can Covid Affect Your Heart?

The coronavirus pandemic is a time for extra vigilance and that is especially important for adults with a history of heart disease, heart disease or stroke, said Saeed Shaikh, M.D., an interventional cardiologist with the Franciscan Medical Network of Indiana and a cardiologist in Crawfordsville. Heart disease and heart failure are also a serious problem. The COVID-19 coronavirus attacks the lungs, not the heart tissue, but the heart is affected because it works so hard to pump oxygen-rich blood through the body and researchers have found heart damage in about a quarter of patients hospitalized with a Covid-19 infection. 

Symptoms like palpitations, dizziness, chest pain and shortness of breath, which are common in long-range coronavirus - flyers, can be a result of heart problems before they develop COVID-19. For people who have already had COVID, persistent COVID heart problems can complicate their recovery. 

In the latest twist, health experts worry about the potential for an increase in heart failure. A growing number of studies suggest that many survivors of COVID-19 can suffer some form of heart damage, even if they do not have any underlying heart disease and are not ill enough to be hospitalized. Fonarow says complications such as myocarditis or inflammation of the heart muscle could later lead to increased heart failure. 

Fonarow is concerned that people with pre-existing cardiac conditions who do not have COVID-19 may avoid going to hospital with heart problems for fear of being exposed to the virus. We know that patients with severe coronavirus cases, who have heart muscle damage as shown in blood tests, are at a higher risk of death in hospital. 

Heart damage is due to severe inflammation that circulates throughout the body. Coronavirus infections can affect the inner surfaces of veins and arteries and cause inflammation of blood vessels which can damage small vessels and clots and compromise blood flow to the heart and other parts of the body. The body's immune system fights the virus, but the inflammatory process can damage healthy tissue, including the heart. 

One effect that Dr. Teresa Daniele, director of cardiology at UCSF Fresno, has observed is myocarditis, inflammation of the heart caused by a viral infection such as COVID-19. Inflammation can cause heart muscle weakness, scarring, life-threatening arrhythmias and arrhythmias. Heart problems such as breathlessness, chest pain and palpitations can be caused by other factors, such as the after-effects of illness, prolonged inactivity and weeks of convalescence in bed, she says. 

A small number of severe cases of COVID-19 can cause heart muscle inflammation (myocarditis) or mucosa (pericarditis) inflammation. This inflammation can also be caused by other viral infections, not just COVID. One way COVID can affect the heart is to invade the heart muscle itself, which causes inflammation in the muscle and permanent damage (muscle scarring and muscle cell death) in severe cases. 

If it is caused by a coronavirus infection, it is known as myocarditis and is a common cause of heart failure. The virus damages the heart and slows down the flow of blood from the heart to the brain. Images suggest that inflammation may occur, and in some documented cases, heart biopsies and autopsies have shown that the virus was present in the heart associated with the disease. 

The symptoms of lung injury and disease can be the same in people with heart disease. People with peripheral arterial disease (PAD) are at higher risk of complications from COVID-19 because many of them have diabetes or heart disease, which are critical conditions that can worsen the outcomes of COVID infection. Patients with congenital heart defects (congenital defects that have not been corrected) also have a higher risk of complications caused by the virus because their blood circulation may be impaired. 

During the pandemic, doctors found that people with heart disease were more likely than others to develop severe COVID-19. Although initially unnoticed, experts are beginning to notice that the virus can cause a variety of heart problems, including myocarditis or inflammation of the heart muscle. Imaging tests, which can take months to recover from the virus, show long-lasting damage to the heart muscle in people with mild Covid-19 symptoms. 

This may increase the risk of heart failure and other heart complications in the future. COVID-19 can cause fever and inflammation, which puts additional strain on the heart while your body fights the infection. A type of pneumonia associated with the virus can cause long-term damage to the small air sacs (alveoli) in the lungs. 

The additional strain on the heart, coupled with a lack of oxygen and nutrients, can damage the heart muscle. If the infection is severe enough, it can damage the lungs and reduce the amount of oxygen reaching the heart. The virus and immune reaction to it can also damage the cells that supply the blood vessels: this can cause clots in the blood vessels that supply the lungs and restrict the supply of oxygen, nutrients and the heart. 

Researchers suspect that SARS-CoV-2 causes heart tissue damage because it has a distinct protein spine that attaches to and penetrates heart cells and binds to the heart's angiotensin-2 receptor (ACE2). The immune response to damage to heart tissue reduces the blood supply to the heart and increases the risk of heart inflammation. Two studies published in JAMA Cardiology on Monday suggest that the virus in many patients - a chronic and progressive disease in which the heart's ability to pump blood through the body declines - cardiac failure is the herald of heart failure. 

Before the start of the pandemic it was known that people with cardiovascular problems such as high blood pressure, coronary heart disease or heart failure had a higher risk of infection and death than those without underlying cardiovascular problems. But when the link between COVID-19 and blood clots became apparent, doctors began linking pulmonary embolism, strokes and heart attacks they saw to the virus. It is too early to say whether the damage to patients recovering from the virus is temporary or permanent, but cardiologists are concerned. 

In JAMA's cardiological analysis, autopsies of 39 COVID-19 patients found heart infections in patients who had not previously been diagnosed with cardiovascular problems when they were ill. The study JAMA used cardiac MRI scans from 100 people who had recovered from Covid-19 in the past two to three months. The researchers found abnormalities in the heart in 78% of the recovered patients and persistent heart muscle inflammation in 60%.

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