What to Know About COVID’s Connection to Heart Problems
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When Jacqueline Saenz caught COVID in September 2021, the 49-year-old accounting technician knew the virus might cause lung problems. Sure enough, she struggled to breathe and wound up on oxygen in the hospital, then at home for months afterward.
What she never expected was that COVID could also damage her heart in ways that are still affecting her more than two years later. For months after Saenz was COVID-free, as she lay in bed each night, she felt intense pressure in her chest and the fluttering of her heart.
“I was really scared. I kept thinking, I’m too young to have heart issues,” Saenz recalls. She delayed seeing her doctor because of fear, denial, and scheduling issues, but she eventually saw a cardiologist who diagnosed a condition known as premature ventricular contractions (PVC), in which extra heartbeats disrupt the heart’s rhythm. Since then, Saenz has worn heart monitors at home, and she takes prescription beta-blockers. Fortunately, the symptoms have improved, meaning she lucked out in avoiding the invasive surgery her doctor had told her she might need.
The COVID-heart connection
When the pandemic initially tore through the world, physicians paid close attention to COVID’s effects on the lungs. After all, COVID is a respiratory disease, says Giv Heidari, M.D., a cardiologist at the COVID-19 Heart Clinic in California’s Loma Linda University Health, where Saenz is being treated. But it’s now clear that numerous other organs—including the kidneys, the GI tract, and the heart—can be affected.
Heart problems in particular are widespread—and really dangerous. Data from the Centers for Disease Control and Prevention shows that 5% more people died from heart disease during the pandemic’s first two years than would have absent the virus. Many cardiac diseases have been linked to COVID: Rates of heart attack, heart failure, pulmonary embolism, stroke, and heart rhythm issues all increase within a year of infection, according to a large study of more than half a million adults. Younger people—typically at low risk—are especially vulnerable to COVID-related heart attacks, with the sharpest relative rise in deaths occurring in people ages 25 to 44, research by Los Angeles’ Cedars-Sinai Medical Center shows.
Exactly how much of this is due to COVID’s effects on the body is under debate. A portion of the jump in heart conditions likely reflects the fact that some people who had early heart disease at the start of the pandemic avoided doctors and hospitals, leading small problems to mushroom into bigger ones. Another part might be the tremendous stress we were all under, not to mention our avoiding the gym and chowing down on greasy, artery-damaging comfort food during long periods at home.
Yet some of the increase was attributable to COVID itself. “The virus can directly affect the heart, such as by inflaming the cardiac muscle or the layers around it. It may also cause dysregulation of neuron fibers feeding the heart, whether via direct effect or through immune system activation,” Dr. Heidari says. Plus, long COVID, which affects some 11% of those infected, frequently includes a cardiac component, such as glitches in the autonomic nervous system that trigger palpitations.
What we don’t yet know is whether there’s heart damage that isn’t resulting in heart disease symptoms now but is setting the stage for future heart problems. For example, COVID infections have been shown to cause inflammation of blood vessel walls. This can theoretically lead to atherosclerosis and coronary artery disease later on—that’s one of the reasons COVID has been called a vascular disease too. Especially worrisome: Some 21% of those hospitalized for COVID develop hypertension for the first time within a few months, as do 11% of those with milder cases—boosting their risk of future issues like coronary artery disease and congestive heart failure.
Who is most at risk for COVID-related heart problems?
The number of COVID-related cardiac patients streaming into Dr. Heidari’s clinic has been declining, perhaps because of the increased immunity most people now have along with the fact that circulating COVID variants are now sometimes milder. What this means for generally healthy people is unclear. “Currently, whether people with SARS-CoV-2 infection have to worry about cardiovascular disease is not known,” says Harlan Krumholz, M.D., a cardiologist at the Yale University School of Medicine. “This is an issue that deserves continued attention.”
Still, the bottom line is that anyone can develop heart symptoms during or after a battle with COVID, and people with additional medical conditions are especially vulnerable. More than a decade before contracting COVID, Jen Singer, 57, a writer in Red Bank, NJ, had rounds of strong chemotherapy along with radiation to her chest in a successful fight against Stage III non-Hodgkin’s lymphoma. Nobody warned Singer then that the treatments had made her heart vulnerable, but six weeks after she got COVID, her heart’s electrical system shut down. She would have died without emergency medical care, including getting a pacemaker inserted, and going on four different heart meds.
Now Singer, who has since published several Just Diagnosed Guides to medical conditions including heart disease, lives with heart failure (insufficient blood flow to the organs), so she’s frequently fatigued and short of breath. “I was a tennis-playing, gym-going, otherwise healthy person until COVID. Chemo and radiation filled the barn with dynamite, and COVID lit the match,” she says.
How to protect your heart after COVID
No one can absolutely guarantee that you can avoid heart complications after COVID, but you can reduce your odds. The best way is to do everything within your power to keep from getting COVID—by avoiding crowded indoor situations when the virus is circulating locally, wearing a mask, and getting the latest vaccine. Some people have heard that earlier versions of the shots could cause a kind of heart muscle inflammation known as myocarditis, especially in young men, but the CDC found that these men were up to eight times as likely to develop the problem after a COVID infection as after vaccination.
If you get sick, take time to rest, which seems to reduce the chance of lingering problems, Dr. Heidari says. And if you notice anything weird going on with your heart (whether or not you’ve had COVID), don’t ignore it. “Anyone who feels they have heart symptoms, especially the onset of chest pain or shortness of breath, should contact their doctor—and for heart attacks time matters, so they should do it immediately,” Dr. Krumholz advises.
Of course, you’ll want to keep your heart as strong as possible by exercising regularly, eating a heart-healthy Mediterranean diet, staying at a healthy weight, not smoking or vaping, and having your BP and cholesterol checked during regular doctor’s appointments. Says Dr. Krumholz, “With risks rising, it is more important than ever to embrace heart-healthy habits.”
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