Editor’s note: This article was published on October 19, 2020. COVID-19 information and recommendations are subject to change. For the most up-to-date information, visit the Centers for Disease Control and Prevention (CDC) website or view our most recent COVID-19 blog posts.
As we continue to learn about how COVID-19 effects people, one of the concerning discoveries is the long-term impact the virus may have on the heart.
“A growing number of studies suggest many COVID survivors experience some type of heart damage, even if they didn’t have underlying heart disease and weren’t sick enough to be hospitalized,” according to the American Heart Association. “This latest twist has health care experts worried about a potential increase in heart failure.”
Dr. Shereif Rezkalla, a Marshfield Clinic Health System cardiologist, said it was initially thought COVID mostly impacted the lungs. As we’ve learned more, we’re finding that the virus can attach to many organs in the body.
Early studies raise concerns
Rezkalla said data coming out of New York, which was an early epicenter of the pandemic in America, showed something alarming. In 36 percent of COVID patients who were studied, researchers found elevated levels of troponin, an enzyme that usually increases when there has been an injury to the heart.
Among the heart complications COVID may create are inflammation of the heart muscle and the forming of blood clots in the vessels of the heart. What that means for each person varies.
Symptoms vary widely
“An analysis of multiple studies on heart inflammation in COVID patients showed that the symptoms range from mild disease to very severe inflammation that can end in death,” Rezkalla said. “The most important thing for doctors to know is that cardiac involvement is common with COVID.”
If a physician finds an increase in troponin, Rezkalla said an echocardiogram, which is an ultrasound of the heart, should be ordered immediately.
Treating heart inflammation
COVID may affect the heart in many ways. The most common is heart inflammation. The inflammation may occur from direct viral invasion of the heart muscle, or from toxic effects of cytokine storm. Cytokine storm is defined by the National Institutes of Health as, “A severe immune reaction in which the body releases too many cytokines into the blood too quickly. Cytokines play an important role in normal immune responses, but having a large amount of them released in the body all at once can be harmful.”
Heart attack and coronary artery inflammation have been reported in association with COVID as well.
One of the ways to treat heart inflammation is through the use of medication that inhibits enzyme production in the body, called an angiotensin converting enzyme. Rezkalla said the benefit of this medication is higher if utilized early in the course of the disease.
People with previous heart conditions are more likely to experience heart-related complications from COVID. Those complications also are more likely to be severe in those with pre-existing heart conditions.
Strenuous exercise is not recommended for patients who have heart inflammation. If you’ve had COVID and you’re concerned about heart complications, talk with your provider.