COVID-19 is a respiratory illness, meaning those who get it often have symptoms like a cough, tiredness, headache and/or fever. More severe reactions to the virus may include shortness of breath. While the virus takes a toll on the lungs, Dr. Todd Langager, Cardiovascular Medical Director for UnityPoint Health, says our experience with the virus proves it can cause short and long-term damage to the heart and cardiovascular system as well.
COVID-19 Heart Damage Symptoms
COVID-19 causes a severe inflammatory response in the body, which impacts multiple organs – and the heart is one of them. COVID-19 can both directly and indirectly impact the heart, including:
- Heart attack (myocardial infarction)
- Fluid around the heart (pericardial effusion)
- Weakness of the heart (cardiomyopathy)
- Heart rhythm conditions (heart arrhythmia)
- Racing heart (heart palpitations)
- Heart muscle inflammation (myocarditis)
- Broken heart syndrome
- Heart failure
If you are experiencing severe chest pain or other heart attack symptoms, please call 911 immediately.
How Does COVID-19 Affect Your Heart?
“When your body gets attacked by something like COVID, it causes the body to release more chemical substances, which causes inflammation. The body has mechanisms to protect against some level of inflammation, but too many chemicals being released is bad – causing more inflammation than the body can handle,” Dr. Langager says.
This inflammatory response can impact multiple organs, including the heart.
Can COVID-19 Cause Heart Attacks?
The COVID-19 virus can cause a variety of heart issues, including heart attacks.
“COVID induces a strong inflammatory response in the body. That inflammatory response in people who have heart disease can cause a blood clot to form within a blockage (plaque) causing the classic heart attack. People who experience this must go to the cath lab (catheterization laboratory) to get a stent or similar procedure to get the blockage open,” Dr. Langager says.
Due to all the inflammation, COVID can also cause heart damage without necessarily leading to a heart attack. This damage may be temporary or permanent.
Can COVID-19 Cause Heart Inflammation (Myocarditis)?
The heart inflammation caused by COVID-19 can directly cause myocarditis. Myocarditis is inflammation of the heart muscle that can impact a heart’s ability to pump, leading to hazardous heart rhythms. When someone has this condition, it can be very dangerous to exercise.
“That’s why there’s so much concern about athletes who contract COVID-19. The exertion put into their sport, with a damaged heart from myocarditis, can cause dangerous heart rhythms, which is known to lead to sudden death,” Dr. Langager says.
Can the COVID-19 Vaccine Cause Heart Inflammation?
While the virus that causes COVID-19 can cause heart inflammation, rarely, so can the COVID-19 mRNA vaccines (Pfizer and Moderna). According to the CDC, there's a very minor risk of myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the outer lining of the heart) in adolescents and young adults after receiving the COVID-19 vaccine.
Confirmed cases of heart inflammation have occurred:
- Mostly in male adolescents and young adults age 16 or older
- More often after the second dose, rather than the first
- Within several days after the COVID-19 vaccination
Symptoms of myocarditis or pericarditis include:
- Chest pain
- Shortness of breath
Most cases of heart inflammation following the COVID-19 vaccine are mild and responded well to medications and rest. No deaths have been associated with the side effect. Researchers continue to track heart inflammation cases to learn more and monitor any long-term risks. As a precaution, the U.S. Food and Drug Administration (FDA) added a warning to patient and provider fact sheets.
Overall, heart inflammation is an extremely rare side effect of the COVID-19 vaccine. In fact, heart inflammation is much more common if you get the COVID-19 virus. It’s highly recommended everyone 12 and older get the COVID-19 vaccine to protect themselves, their families, their communities and enjoy what it’s like to safely return to more normal activities.
Can COVID-19 Cause Broken Heart Syndrome?
COVID-19 also causes what’s known as broken heart syndrome. The stress on the body from the virus can make some people feel like they're having a heart attack, even when there’s not actually a blockage.
“The theory behind broken heart syndrome is rather simple. Stress, either physical or emotional, causes a sudden surge of adrenaline in the body that puts stress on the heart in a manner that makes it seem like there’s a heart attack,” Dr. Langager says.
Can Heart Issue Happen Post-COVID-19?
COVID-19 can cause both short-term and long-term effects on the heart.
“We know more about the short-term effects in people who’ve been hospitalized from COVID-19. Those usually include blood clot issues, heart attacks due to blockages, abnormal heart rhythm conditions and broken heart syndrome. It’s the long-term effects of COVID-19 on the heart that we are only now starting to get a handle on,” Dr. Langager says.
Those who experience long-term effects of COVID-19 are often referred to as “long-haulers.” Extensive studies haven’t been done on this group yet since the virus is still very new. Research tells us people can experience a variety of symptoms long after recovering from the virus – some of which involve the lungs, the heart or other reactions that can’t be pinpointed to a specific organ.
“Those who’ve contracted COVID-19 and their care teams need to pay attention to all symptoms closely, even after someone appears to have recovered from the virus,” Dr. Langager says.
Who is Most Likely to Experience Heart Issues From COVID-19?
Anyone who contracts COVID-19 could experience a heart issue. It doesn’t matter if you experience no symptoms (asymptomatic), a mild case or a severe case resulting in hospitalization. Dr. Langager says we don’t know how common heart issues are just yet, but there are a couple things we do know from early research.
“Twenty to 25 percent of people who are hospitalized with COVID-19 will experience some sort of heart issue. We know about those patients because they’ve been studied in the hospital. What we don’t know is the true extent of heart issues in people who haven’t been hospitalized. There are some studies emerging that a significant number show impacts on the heart when checked months later. Those heart issues weren’t identified immediately, because they weren’t hospitalized,” he says.
What Heart Tests Can be Done for Those with COVID-19?
“There are no firm guidelines around heart-related testing following an infection with COVID-19. However, those who are hospitalized and showcase evidence of heart damage from the virus would require follow up with their doctor and, likely, a cardiologist. The heart tests that can be used include an electrocardiogram (EKG), chest x-ray, blood test to identify muscle damage to the heart, an ultrasound of the heart and, in occasional circumstances, an MRI of the heart. Those are all the options available, but most people wouldn’t need all of them,” Dr. Langager says.
The only firm testing guidelines are when myocarditis (heart muscle inflammation) surfaces. That would require a follow up at three to six months to make sure the heart inflammation has been reduced and it’s safe for exercise.
Post-COVID Heart Care and Treatment
Dr. Langager says be on the lookout for COVID heart damage symptoms including:
- Chest pain
- Increased shortness of breath
- Palpitations of the heart (either skipping beats or rapid beating)
- Blackout spells
- Changes in physical ability (like not being able to climb the stairs)
“Those are the general COVID-19 heart damage symptoms that should raise the red flag that it’s time to seek help. If you’ve had COVID-19 and start experiencing these symptoms, make sure to tell your care team. Many physicians are learning this virus can impact the heart to a greater degree than once thought,” Dr. Langager says.
Can I Protect My Heart Against COVID-19?
The best way to protect yourself is a heart-healthy lifestyle, avoid contracting the virus and get the COVID-19 vaccine.
“This advice is especially important for those in the 65 and older age group. These people are at high risk of contracting a severe case of COVID-19. They're also at a higher risk for developing heart-related issues from the virus. In addition, this group has a higher likelihood of diabetes, and those with diabetes can’t fight the infection as well,” Dr. Langager says.
If you have any questions about your personal heart health, reach out to your doctor for advice.