Can a COVID-19 infection affect the heart?
If you had a COVID-19 infection, and are now experiencing heart issues you didn’t have before, your heart issues may be related to the COVID-19 infection. The two most common issues are inflammation of the heart muscle which is myocarditis, and inflammation of the covering of the heart which is pericarditis. A COVID-19 infection can also cause inflammation of blood vessels, known as vasculitis, which can lead to an acute myocardial infarction, or heart attack.
A COVID-19 infection can cause abnormal heartbeats (arrhythmias), heart failure, myocarditis, pericarditis and acute blockages. Chronic ongoing heart issues can cause more permanent damage to the heart, resulting in scarring of the heart muscle which puts patients at high risk for cardiac arrhythmias that could result in heart failure or sudden cardiac arrest. Chronic inflammation can cause longer-term atherosclerosis (blockage of arteries) and longer-term coronary effusions (accumulation of fluid around the heart).
Heart issues caused by a COVID-19 infection can also be related to dysautonomia, or nervous system disorders. This condition is what is known as “long COVID”.
While any person’s COVID-19 infection could affect their heart, young men are especially susceptible because their symptoms may not be properly addressed and could worsen over time leading to greater complications.
People with certain comorbidities may be more likely to have heart issues after a COVID-19 infection. Comorbidities may include:
- Obesity
- Cardiac heart diseases
- Heart failure
- Renal disease
- Lung disease
Although the probability of being impacted by heart issues after a COVID-19 infection is significantly higher when paired with any comorbidities, they also occur in people with absolutely no risk factors.
The vast majority of patients with heart issues after a COVID-19 infection do not have any underlying risk factors.
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Symptoms of Heart Issues Related to a COVID-19 Infection
Symptoms of heart issues related to a COVID-19 infection may include:
- Significant chest pain
- Rapid or irregular heartbeat
- Shortness of breath
- Lightheadedness
- Syncope or fainting spells
- Chronic fatigue
- Atrial fibrillation (Afib)
- Premature ventricular complexes (PVCs)
- Ventricular tachycardia (VT)
These symptoms, if left untreated, can worsen to cause heart failure or even lead to sudden cardiac death.
Diagnosis
Patients will be asked about their symptoms and if any prior testing or analysis has been done.
Diagnostic testing will seek to address the patient’s symptoms, and may include:
- Electrocardiogram (ECG, EKG)
- Ultrasound
- Echocardiogram
- Cardiac MRI
- CT scan
- Heart monitor
- Cardiac fluorodeoxyglucose (FDG) positron emission tomography
Autonomic testing may be used to diagnose dysautonomia. KCHRI has a full scale of autonomic testing equipment to appropriately diagnose this condition. This may involve coronary angiography, bloodwork and/or a high-sensitive C-reactive protein (CRP) test to look for inflammatory markers.
Treatment Options
Patients with heart issues after a COVID-19 infection are typically treated with immunosuppressant therapy, which includes medications to suppress the inflammation along with repeat testing to ensure that the inflammation has been addressed. We may also prescribe antiarrhythmic heart medications to slow down the heartrate.
If patients have electrical conduction system abnormalities – also known as heart blocks – along with a slow heartbeat, they may need a pacemaker or a defibrillator. Patients who have residual scar tissue and significant ventricular arrhythmias may need an implantable cardiac defibrillator.
In patients experiencing heart failure, we offer options such as cardiac resynchronization therapy devices and a radiofrequency catheter ablation procedure for those with residual arrhythmias that do not resolve even after the inflammation goes away. Because of the scar tissue it leaves behind, oftentimes people may have permanent damage to the heart if the symptoms are not addressed in a timely fashion. These are the patients who may need catheter ablations.
At KCHRI, we have a very comprehensive team of electrophysiologists, cardiac imaging specialists, interventional cardiologists, and heart failure specialists as part of our team to provide comprehensive care for cardiac conditions related to COVID-19 infections.