COVID Heart Damage

Can COVID-19 cause heart problems?

COVID-19 can impact your heart in a number of ways. It’s very rare for the virus that causes COVID-19 to directly infect your heart muscle. Usually, it causes problems throughout your body that lead to heart damage.

COVID-19 can lead to heart problems among people who never had heart issues before. But if you have cardiovascular disease, you face the greatest risk of heart problems. If you have heart disease risk factors, such as high blood pressure, diabetes, obesity or high cholesterol, you also face a higher risk of serious complications. COVID-19 can impact your heart while you’re sick but also after the virus has left your body.

How does COVID-19 affect your cardiovascular system?

Some heart problems can show up while you’re infected or hospitalized with COVID-19. These heart problems are called “myocardial injury.” Myocardial injury means that cells in your heart muscle have died. Sometimes, people with myocardial injury don’t have any heart disease symptoms. Instead, they’re diagnosed through blood tests or cardiac imaging. Others might have symptoms like chest pain or shortness of breath (dyspnea).

Researchers are still learning how many people with COVID-19 experience myocardial injury. Estimates range from 7% to 40%. Myocardial injury is more common among people who need care in the ICU. If you have heart damage, you face a higher risk of complications as your body tries to fight off the virus.

Inflammation from COVID-19 leads to heart damage

Early research suggests inflammation leads to COVID-19 heart damage. When you first become infected, your body activates your immune system. This leads to the production of inflammatory cells and cytokines. Cytokines are small proteins that activate your immune response. This process of inflammation is necessary and helpful to your body.

But COVID-19 causes too much inflammation for some people. This condition is called cytokine release syndrome (or “cytokine storm”). It often happens in severe COVID-19 cases. Excessive inflammation can harm your cardiovascular system in many different ways, including:

• Arrhythmia. Inflammation can interrupt your heart’s electrical signals. As a result, your heart can lose its normal rhythm. If you already have arrhythmia, the cytokine storm can make it worse.
• Blood clots. The lining of your blood vessels (the endothelium) can become inflamed. When this happens, you face a greater risk of blood clots, heart attack or stroke.
• Myocarditis. This is an inflammation of your heart muscle. People with COVID-19 face a higher risk of myocarditis compared with those who aren’t sick.
• Pericarditis, an inflammation of the membrane surrounding your heart, can cause chest pain and fluid to accumulate around your heart.
• Heart failure, a condition where excess fluid and swelling (edema) can build up in your body.

People with cardiovascular disease or risk factors face higher risks of heart damage

Many people hospitalized for COVID-19 have underlying heart issues. And people with cardiovascular disease are more likely to experience a cytokine storm.

If you have any of the following conditions, you face a higher risk of COVID-19 complications:

• Heart failure.
• Coronary artery disease.
• Diabetes.
• Overweight/obesity.
• History of a stroke.
• High blood pressure (hypertension).
• Sickle cell disease.
• Thalassemias.

Does COVID-19 cause a heart attack or stroke?

COVID-19 may increase your risk of a heart attack or stroke, especially if you’re hospitalized. But researchers continue to explore this topic. Inflammation is the main culprit. It raises your risk of blood clots and prevents your body from getting rid of clots on its own.

Such blood clots also prevent oxygen from reaching your organs, including your heart. When this happens, you’re at risk of having a heart attack. This means that your heart isn’t getting enough oxygen-rich blood.

An enzyme called troponin may help doctors diagnose a heart attack.

Don’t delay medical appointments or emergency care

Researchers will continue learning about how COVID-19 affects your heart. Meanwhile, heart attacks still happen every day among people who don’t have COVID-19.

During the pandemic, many people avoided doctor’s appointments and hospitals. While it’s normal to worry about catching COVID-19, you should not delay care. It’s much safer to visit a doctor’s office or hospital than to ignore life-threatening symptoms.

Call 911 immediately if have heart attack symptoms. Prompt care is essential to prevent further heart damage. Also, keep up with your regular medical appointments. Tell your healthcare provider about any new symptoms or problems. And if you had COVID, discuss how it affected your body.

Will I have heart issues after COVID-19?

Some people have heart issues after COVID-19. Your risk is higher if you needed ICU care or were on a ventilator. But even those with mild cases can still experience heart problems down the road.

Such problems can happen if you develop long COVID. This is also known as post-acute coronavirus (COVID-19) syndrome. If you have long COVID, your health isn’t back to where it was before getting sick. Healthcare providers consider the four-week mark significant. If you still are having problems four weeks after getting infected, you have long COVID. This can impact you in several different ways.

New or lingering symptoms

COVID-19 can cause new or lingering symptoms in people who were severely ill. But it can also cause lingering problems in people who had mild or asymptomatic COVID. Fatigue, shortness of breath and “brain fog” are among the most common problems. Symptoms that could be related to your heart include:

• Chest pain.
• Heart palpitations.
• Fast heart rate (tachycardia).
• Feeling dizzy or lightheaded.
• Shortness of breath.

If you have any of these symptoms, call your healthcare provider right away to discuss how you’re feeling. Your provider may want to run some tests to check your heart function. These tests include an electrocardiogram (EKG) or echocardiogram.

Effects on multiple organs

COVID-19 can affect many organs and systems such as your heart, lungs, brain and kidneys.

SARS-CoV-2 attaches its spike protein to enzymes in your body called ACE2 enzymes. These are proteins that you have throughout your body, including your heart and lungs. The ACE2 enzymes are also in the lining of your blood vessels. SARS-CoV-2 can easily attach to your ACE2 enzymes. As a result, the virus can spread to many organs and damage them.

• Lungs. COVID-19 can damage your lungs more severely than the flu. Severe COVID-19 cases can cause your lung tissue to become thickened and scarred. This is called fibrosis.
• Brain. COVID-19 can harm your brain by preventing it from getting enough oxygen.
• Kidneys. COVID-19 can reduce your kidney function.

COVID-19 can affect your whole body. So it’s important to take precautions to avoid becoming infected. Getting vaccinated is the best way to protect yourself and others. Also, wear a well-fitted mask in public places, stay home if you’re sick and wash your hands often.

Effects of treatment and hospitalization

Problems related to treatments and extended hospital care are not unique to COVID-19. You might feel very weak and tired. Or you might develop symptoms of Post-Traumatic Stress Disorder (PTSD).

Talk with your provider about how you’re feeling. It’s normal not to feel OK for a while after battling COVID-19. Give yourself time to heal and adjust back to your regular routine. You’re definitely not alone. Your provider will work with you to determine how best to support your recovery.

A note from Cleveland Clinic

If you or a loved one have been diagnosed with COVID-19, you probably have lots of questions. One of those questions might be whether COVID-19 can cause heart issues. Because the disease is so new, researchers also have lots of questions. They’re still learning how it affects our bodies. Early research shows COVID-19 can cause serious problems for people with cardiovascular disease. That’s why it’s so important to take precautions to keep yourself and those you love safe. Talk with your healthcare provider about vaccination and other measures to protect your heart and your whole body.