During the COVID-19 pandemic Earth’s residents were confronted with unprecedented levels of disruption. Virtually every aspect of where we go and what we do was impacted by the threat of the disease. One fact became quite clear as the pandemic progressed—people with existing health issues like diabetes, obesity, and cardiovascular disease were at an elevated risk to experience a severe or lethal infection of COVID-19.¹ These conditions also influenced the degree to which COVID-19 could affect the heart.²

What about an individual with no prior history of heart issues? Is he or she more likely to experience cardiac problems after COVID-19 infection? This and other questions regarding COVID-19 and the heart are being answered as researchers now gain access to a vast amount of medical data.

COVID-19 Impacts Even Healthy Hearts

Post-mortem analysis of heart tissue from people who died of COVID-19 reveals several consistent patterns.³

• Micro-blood clots
• Inflammatory invasion of heart tissue
  1. Although often not severe enough to be expressed in symptoms
• Dysregulation of clotting response in immunity
• Even mild cases of COVID-19 display increased risk of:
  1. Cardiac inflammation
  2. Cardiovascular disorders
  3. Cardiovascular death

COVID-19 infection in people without previous history of cardiac dysfunction does negatively impact cardiac health. One common theory regarding COVID-19 and heart damage has disruption of proper lung function as the initial problem. In this process the lungs do not get adequate oxygen to the heart, which is weakened or damaged and cannot pump enough oxygenated blood to all the other tissues in the body.³

Inflammation: Driver of Disease

In response to viral infection, the body produces inflammatory agents. These do good work when they operate in a balanced way, but with COVID-19, inflammation may run out of control and actually do serious harm. The heart may be one area that suffers when inflammation exceeds its limits. One common result is the emergence or exacerbation of heart arrhythmia.³ Elevated inflammation may also be the cause of the many small blood clots that are common throughout the bodies of people who fall seriously ill with COVID-19.

Severe COVID-19 May Scar the Heart

When heart tissue is damaged the blood will indicate the damage with the presence of a protein called troponin. MRI scans reveal that people with high troponin levels who endured and survived severe COVID-19 infection are twice as likely to display scarring in heart tissue.⁴ This means that it is likely that heart attack (myocardial infarction) to some degree has occurred during the infection.

Involvement of the heart in COVID-19 infection is associated with worse outcomes. The most common heart problems associated with COVID-19 are listed here.⁵

• Inflammation of the heart (Myocarditis)
• Heart attack (Myocardial infarction)
• Sudden blockage of lung circulation (Pulmonary embolism)
• Arrhythmia
• Valve damage
• Inflammation of the fluid filled sac surrounding the heart (Pericarditis)

Large Study Confirms Dangers to Heart from COVID-19

A large investigation of over 150,000 COVID patients in the Veterans Health Administration (VHA) system produced surprising results regarding long-term risk of heart problems after COVID-19 infection. The outcomes of these patients were compared with over 5 million patients with no apparent COVID-19 infection. Here are the major takeaways from the study. 

• One year after being diagnosed with COVID people had an elevated risk of various heart problems
  • Arrhythmia
  • Stroke
  • Blood clots in legs and lungs
  • Heart failure
  • Heart attack
• Risk is elevated even for people with the following characteristics
  • Optimal BMI
  • Athletic
  • Non-smoker
  • No comorbidities (like kidney disease and diabetes)
• Risk is elevated regardless of COVID-19 severity
  • Although severe disease caused a greater risk

Symptoms to Be Aware of

Heart problems that arise from COVID-19 infection may be indicated by the following symptoms.⁶

• Palpitations
• Dizziness
• Shortness of breath
• Chest pain

It is a good idea to have a device called an oximeter on hand to check oxygen saturation in the blood when symptoms occur. If oxygen saturation falls below 92 percent it is best to seek medical attention.

Heart failure can happen as a result of COVID-19 infection. This may be the cause of shortness of breath experienced with the infection, but it also may just be the result of not being active and poor fitness. However, if breathing difficulty is accompanied by swelling in the legs, then you need to contact your doctor.

Get Checked Following Severe COVID-19 Infection

Heart complications following COVID-19 infection should be recognized as a real threat to our health. If you are experiencing any of the symptoms mentioned in this article, be sure to make an appointment with your doctor and tell him or her what you are experiencing. Our bodies are very resilient, but sometimes they may need a little help in the healing process.

The COVID-19 pandemic enveloped our planet in an atmosphere of fear. Taking the proper steps to protect the heart can help us retain peace of mind. Remember that practicing a healthy lifestyle, such as eating a whole-food plant-based diet and exercising regularly, will reduce the inflammation that drives disease. Explore our website for healthy, tasty recipes and other tips. When we pile more good things on the good side of the scale, our odds for maintaining excellent heart health improve dramatically. 

For more information or if you would like an appointment with Dr. Facemire please visit us at provider.kareo.com/dr-anabel-facemire.