Covid and Your Heart: COVID-19 Effects on Heart Health

Early in the pandemic, experts found out that people with heart disease were twice as likely to contract COVID-19 than the general population. It was also found out that pre-existing heart illnesses and poor metabolic health could increase the risk of severe COVID-19.

In the early months of the pandemic, the reasons were not known. But now we finally have two explanations:

• Pre-existing heart conditions: Heart muscle damage or blockage in heart arteries tend to weaken the body’s fighting power to relieve the stress caused during the illness. Moreover, a person with such vulnerable heart is more likely to fall victim to the ill effects of fever, low oxygen levels, unstable blood pressure, and blood clotting disorders, all classical signs and consequences of COVID-19, than someone with a healthy heart.
• Poor metabolic health: It is more common in people suffering from heart disease. Poor metabolic health may refer to conditions such as prediabetes, type 2 diabetes, or obesity. These diseases are known to cause inflammation and an increased risk of blood clots, thereby intensifying the effects of COVID-19 and the likelihood of its life-threatening complications.

How COVID-19 causes heart damage

Yes, being a respiratory virus and all, how does it affect the heart exactly? Well, the SARS-CoV-2 virus (Severe acute respiratory syndrome coronavirus 2) can cause damage in several ways. For example, the virus may invade the heart muscle directly or cause inflammation, and may disrupt the oxygen supply balance and demand.

Laboratory blood analysis of multiple patients affected with severe COVID-19 illness revealed the presence of an enzyme named troponin in large quantities.

Normally, this enzyme serves as an indicator of heart injury and about one-third of the patients who showed the presence of troponin had pre-existing cardiovascular disease (CVD).

Why is heart muscle inflammation a concern

A majority of COVID-19 patients have mild symptoms and recover fully. However, almost 20% develop pneumonia and 5% develop a severe form of the disease. This causes our body’s immune system to overreact to the infection and release some inflammatory proteins named cytokines in to the bloodstream.

As you probably already know, these cytokines are not particularly good for us and can damage multiple organs, including the heart.

Heart inflammation also called as myocarditis has been reported in patients with advanced stage COVID-19 disease. It occurs when the virus invades the heart directly or more commonly through the cytokines which we just mentioned.

In myocarditis, the heart may become enlarged, weakened, leading to low blood pressure and then accumulating fluid in the lungs.

A recent study revealed that a significant number of patients who recovered from severe COVID-19 were found to have heart inflammation without any symptoms, as per magnetic resonance imaging.

Change in oxygen supply and demand may lead to heart damage

It is well known that fever and infection increase the heart rate, thereby increasing the workload of the heart in COVID-19 patients who develop pneumonia.

Moreover, fluctuations in blood pressure causes further stress on the heart which results in an increase in oxygen demand that can lead to heart damage. This effect can be profound in unhealthy heart arteries or muscle.

Effect of gender on heart rate is pretty much clear as the heart rate is lower in women than in men.Men’s heart tends to be bigger in size and hence it pumps more blood as compared to that of women who have a smaller heart size.

But in case of COVID-19, once contracted, the mortality or death rate in both genders remain the same. Hence, maintaining heart heath irrespective of gender is important.

Why Covid-19 patients are at a greater risk of heart damage

COVID-19 patients possess a great risk of heart damage. Heart damage is usually caused by heart attacks, which are a result of blood clot in a vulnerable heart artery.

A blood clot in the artery blocks the necessary oxygen supply needed for proper functioning of the heart muscle. Such a type of heart attack is more likely to happen due to COVID-19-related inflammation as it activates the body’s clotting system and disrupts the blood vessel lining.

In such a situation, the inflamed lining loses its ability to resist clot formation and thus blocks the oxygen supply to the heart muscle. Furthermore, this increased blood clotting can also be seen in lungs and causes a significant drop in the blood oxygen levels.

In addition, severe pneumonia drops the blood oxygen levels even further. Finally, when this unrealistic oxygen demand exceeds the supply, the heart muscle is bound to get damaged.

Stress cardiomyopathy:

Cardiomyopathy is a heart muscle disorder wherein the heart’s ability to pump blood effectively, weakens.

Viral infections can definitely cause cardiac myopathy and under a viral attack, a stressed body releases a surge of chemicals named catecholamines, which can stun the heart. One thing to note here is that once the infection subsides or resolves, the stress reduces and the heart recovers.

When to visit a doctor?

After learning how and why a bad heart health and COVID-19 can be related, lets understand when to see a doctor if you feel something is wrong with your heart. Read on!

Shortness of breath

You may want to consult a doctor promptly if you have severe shortness of breath. These days it is recommended to keep a commercial O2 (oxygen) saturation monitor handy when you feel shortness of breath.

Generally, these symptoms may be normal after recovering from COVID-19, as most of the patients haven’t been much active after the infection. But if the O2 saturation level is below 92% along with apparent shortness of breath, then it is of concern, and one should visit the doctor immediately.

Also, if you have any leg swelling along with shortness of breath, then it may be a warning sign of heart failure. Do visit your doctor if you have any such symptoms.

Chest pain

Chest pain is also a common post-COVID symptom and could be serious if it persists along with nausea, shortness of breath and light-headedness, which can be a sign of a heart attack. In such circumstances, do visit a doctor.

People recovering from COVID-19 may sometimes show symptoms of a condition named POTS (postural orthostatic tachycardia syndrome).

POTS isn’t a cardiac problem but a neurological one that affects the part of the nervous system that regulates heart rate and blood flow. POTS can cause rapid heartbeats especially when you stand up, which can lead to brain fog, palpitations, fatigue, light-headedness and other symptoms.

Ways to lower the risk of heart diseases through a healthy lifestyle

People with CVDs who adopt healthy lifestyle choices can fight well against COVID-19 and reduce the cardiovascular risk factors and disease itself.

Avoiding physical inactivity, doing regular exercise and following a healthy diet such as Mediterranean diet could make a difference for e.g., by improving heart function and reducing stress levels.

Indulge in activities such as cooking at home when you can, walk outdoors with friends if your preferred gym is temporarily closed. It is also recommended to purchase an inexpensive and handy blood pressure monitor at home which is easy to use.12

Consuming excessive sugar-based foods could lead to insulin resistance and increases the risk of getting type 2 diabetes, which again is a major risk factor to develop heart disease.

Hence, it is highly recommended to limit sugar intake to maintain good heart health and prevent a viral infection such as COVID-19.

Limit your alcohol intake to up to 2 drinks per day and regulate your caffeine consumption to a maximum of four cups of coffee per day. Alcohol and caffeine in higher levels can have detrimental effects on heart health and can increase the risk of contracting COVID-19.

One drink equals to:

• Beer, ale or wine cooler: one can or bottle of 2 ounce
• Red or white wine: one glass of 05 ounce
• Malt liquor: one can or bottle of 8 or 9 ounce
• Distilled spirits (rum, gin, tequila, whiskey or vodka): one 1.5 ounce shot glass

Conclusion

In summary, it COVID-19 affects heart function and health and why it is a risk for those with pre-existing cardiac complications and diseases.

But with every risk, there can be a reward, if we take a decision at the right time with correct information. Following proper medical guidelines and finding out some early signs and reporting them to your doctor could play a major role in preventing any life-threatening heart damages, particularly, in tackling with Covid-19's effects on heart health.