Written By: American Heart Association
Even as vaccines are being distributed across the country, doctors and scientists continue to learn more about COVID-19 and cardiovascular health. Here’s what people with heart conditions should know now.
Conditions such as heart failure (where the heart does not pump blood effectively), coronary artery disease (blocked arteries) and cardiomyopathies (weakening, thinning and/or thickening of the heart muscle) lead to more severe cases of COVID-19, according to the Centers for Disease Control and Prevention.
People with obesity, Type 2 diabetes and a lung-related type of high blood pressure known as pulmonary hypertension are also considered at increased risk, the CDC says. Systemic high blood pressure and cerebrovascular disease, which affects blood vessels in the brain, as in a stroke, might also put people at risk, the agency says. That’s why the American Heart Association encourages people with cardiovascular risk factors, heart disease or a history of heart attack or stroke to get vaccinated as soon as possible.
The main concern is that COVID-19 could cause respiratory stress that would worsen these conditions.
“What we are learning is that COVID-19 is often a systemic illness,” said Dr. Paul Zellers, a cardiologist with Lake Health. “It can cause an over-reactive immune system response leading to multi-organ damage. It can also increase blood clotting. All of these mechanisms can contribute to worsening of underlying cardiac conditions.”
Heart patients should continue their usual medications, such as ACE inhibitors and angiotensin receptor blockers. “Amid the COVID pandemic and the risk of becoming severely ill, it’s of utmost importance to take your cardiac medications religiously,” Dr. Zellers said.
Heart patients are also advised to keep regular doctor’s appointments and not wait to seek emergency care at hospitals. And they shouldn’t hesitate to get vaccinated.
Defeating the pandemic “relies on the concept of herd immunity,” Dr. Zellers said. “For this to work, most of us have to get the vaccine. I would, without a doubt, recommend vaccination to everyone, especially those with heart disease.”
Some COVID-19 patients without existing heart conditions are also facing longer-term issues.
A growing number of studies suggest many COVID-19 survivors experience some type of heart damage, even if they didn’t have underlying heart disease and weren’t sick enough to be hospitalized. This latest twist has health care experts worried about a potential increase in heart failure.
Nearly one-fourth of those hospitalized with COVID-19 have been diagnosed with cardiovascular complications, which have been shown to contribute to roughly 40% of all COVID-19-related deaths.
But two recent studies suggest heart damage among those infected may be more widespread. In JAMA Cardiology, an analysis of autopsies done on 39 COVID-19 patients identified infections in the hearts of patients who had not been diagnosed with cardiovascular issues while they were ill.
Another JAMA Cardiology study used cardiac MRIs on 100 people who had recovered from COVID-19. Researchers found abnormalities in the hearts of 78% recovered patients and “ongoing myocardial inflammation” in 60%. The same study found high levels of the blood enzyme troponin, an indicator of heart damage, in 76% of patients tested, although heart function appeared to be generally preserved. Most patients in the study had not required hospitalization.
Whether screenings to detect cardiovascular damage should become a routine part of follow-up care for COVID-19 patients remains unclear.
People recovering from COVID-19 should watch for the following symptoms and consult their physician or a cardiologist if they experience them.
- Increasing or extreme shortness of breath with exertion
- Chest pain
- Swelling of the ankles
- Heart palpitations or an irregular heartbeat
- Not being able to lie flat without shortness of breath
- Waking up at night short of breath, lightheaded or dizzy