COVID-19 + Heart Disease: What You Need To Know
- Category: Community Newsletter, In The News
- Posted On:
- Written By: Jherie Ducombs, MD
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It’s widely recognized that SARS-CoV-2, better known as COVID-19, impacts most with respiratory illness resulting in conditions that range from very mild to life-threatening. It has also become apparent that adverse cardiovascular impact is common among patients with severe COVID-19 disease and is associated with worse outcomes.
5 Important Things to Know About Your Heart and COVID-19
What do we know so far?
First, people with pre-existing heart and vascular disease are more likely to have severe illness. This does not mean people with heart issues are more likely to contract COVID-19, just more likely to have complications and statistically worse recovery rates. People with the following conditions appear to be particularly at risk:
- High blood pressure
- High cholesterol
- Coronary artery disease
- Previous stroke history
The inflammation that accompanies the COVID-19 infection destabilizes existing plaque and worsens vascular (blood vessel) function, making these diseases worse. This fact is not surprising, as it has been observed with similar illnesses that cause inflammation (e.g., the flu). The increased risk is just one of the many reasons it's essential to actively work to prevent heart disease in your daily life.
Second, emerging data shows that COVID-19 affects not only the lungs, but also the heart. The most common mechanism appears to be the body’s response to overwhelming illness, called a systemic inflammatory response. This exaggerated immune response results in the release of chemicals, including cytokines, which not only defend against the virus but can cause collateral damage to the host (that means you!).
It can also affect the smallest blood vessels, leading to thrombosis (blood clotting) or ischemia (lack of oxygen). COVID-19 related heart disease can show up in the following ways:
- Heart attacks caused by blockage in a heart artery
- Infection or inflammation of the heart muscle, which can lead to weakness, failure or abnormal rhythms of the heart
- Stress-related heart failure
- Severe chest pain – heart attack without blockage
- Other heart muscle injury without a heart attack
Blood tests, electrocardiograms (ECGs) and echocardiograms (ultrasound of the heart) are often used to detect heart muscle injury and evidence of heart failure. Outcomes of patients who contract COVID-19 are typically worse when these tests are abnormal prior to or during diagnosis of the virus.
Third, COVID-19 increases the risk of other vascular diseases like stroke and blood clots. Stroke severity and risk of stroke-related death are worse in individuals infected with the virus.
Fourth, the number of people seeking treatment for everyday emergencies, including heart attacks and strokes, has significantly decreased. The decrease has been reported both here in the United States and abroad. We’re not sure if there’s been an actual reduction in those emergencies. It would seem unlikely since those emergencies typically increase during epidemics of similar illnesses like the flu. There are also reports of people presenting to the hospital late and increased numbers of people found dead in their homes. Some may be reluctant to seek care for fear of contracting COVID-19 or not sure where they can get medical attention. Most ER's remain open for these everyday emergencies. If you aren't sure, call ahead. It's important to seek attention early because early treatment leads to better outcomes and reduces the chance of permanent heart and brain damage.
And fifth, the most important things you can do to stay well at this time include preventing or managing chronic diseases and avoiding virus transmission. As they say, an ounce of prevention is worth a pound of cure.
