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COVID-19 and Heart Health

COVID-19 and Heart Health

When COVID-19 began to take hold across the globe, much of the emphasis was on how the virus affected the lungs. However, there has since been a better understanding of how coronavirus impacts other bodily systems, such as the heart. Even individuals who haven’t had a previous cardiac event, or a history of preexisting heart conditions, may be at risk.

“We certainly see a higher prevalence of cardiac manifestations and cardiac complications in patients who have preexisting heart disease. But, in my personal experience and in the literature, we do see patients who have their first ever heart attack and their first ever heart problems in association with an acute case of COVID-19,” states Dr. Richard Gerber, cardiologist at Salinas Valley Memorial Healthcare System (SVMHS).

To listen to an in-depth conversation on this topic with Dr. Richard Gerber, cardiologist at Salinas Valley Memorial Healthcare System, click here.

How Does the COVID-19 Virus Affect the Heart?

When a patient is infected with the coronavirus, it often sparks an activation of the inflammatory system. This causes an entire cascade of problems, including:

  • Injury to the heart muscle
  • Weakening of the heart
  • Fluid in the lungs
  • Blood clots that can lead to heart attack or stroke
  • Unstable heart rhythms
  • Worsened congestive heart failure

Approximately 25% of patients who are hospitalized with an episode of COVID-19 will have a heart muscle injury, which is frequently detected by measuring a protein in the blood called troponin.

“Troponin is a protein, an enzyme, that’s very specific to the heart muscle. When we can measure that in the blood in association with an episode of a severe COVID-19 illness, there's a much greater risk for adverse outcome—usually meaning a longer hospital stay, a greater need for being put on artificial means of life support, and higher mortality,” explains Dr. Gerber.

If an echocardiogram is also abnormal, in addition to troponin being elevated, the risk goes up further. One study by the American College of Cardiology shows that in hospitalized patients who have no myocardial injury, mortality rate is about 5.2%. If troponin is elevated, that rate can go up to 18-19%. And, if troponin is elevated and the echocardiogram shows a weakened heart muscle, mortality rate can be as high as 32%.

“So, you can see that these patients who have COVID-19 but also have underlying heart disease or whose hearts are affected by the virus, really are in a much, much more dangerous and vulnerable situation,” adds Dr. Gerber.

Are Some Individuals More at Risk than Others?

Data collected to date indicates that the COVID-19 mortality rate in hospitalized patients is higher in men than women, which may be due to hormonal differences. Patients who have the following pre-existing conditions are also at risk for poor outcomes:

  • Obesity or a higher measured adipose fat tissue
  • Diabetes
  • Lipid abnormalities
  • Elevated cholesterol or triglycerides in the blood
  • Systemic hypertension (high blood pressure)

Dr. Gerber also points out that the older one is, the greater the risk for mortality.

Dangers of Delaying Care

A troubling trend that has developed over the course of the pandemic is that many people are delaying care—even for emergencies—out of fear of contracting COVID-19. Dr. Gerber urges people to always put their health first. SVMHS has taken significant measures to ensure the safety of all patients, whether they’re coming to the hospital for COVID-19 or any other condition.

“We have a very effective triage [system] and segregation of patients with and without COVID-19. The emergency department and the hospital really remain a very safe place. We really don't want patients to delay treatment for COVID-19 or for other serious, life-threatening heart and non-cardiac diseases because they're afraid to come to the hospital,” said Dr. Gerber.

Anyone who experiences a sudden onset of heaviness, pressure, burning, tightness, or squeezing in their chest, neck, jaw, shoulder, or arm—or really any sensation that’s unusual, especially if accompanied by an abnormal amount of sweating, dizziness, or breathlessness—should call 911 or head to the ER immediately.

A Word on Vaccines

Dr. Gerber also encourages individuals to get vaccinated when they become eligible to do so. While the vaccine(s) may have an appearance of being “fast tracked,” scientists have been studying the technology used to develop them for years.

“It's really a tribute and a testament to modern science that the pharmaceutical companies were able to develop these effective and safe vaccines in such a short period of time. The public should feel safe that both the effectiveness and the safety of the vaccine have been validated in tens of thousands of patients. If we are going to come out on the other end of this pandemic, which we’re nearly a year in now, we're going to need to have this so-called ‘herd immunity.’ And the way we're going to achieve that is to have everybody get vaccinated as quickly as possible,” said Dr. Gerber.

However, he cautions that the vaccine doesn’t suddenly “solve” everything related to COVID-19. Individuals should remain vigilant in their precautionary practices, just as they have for the last year.

“We need to continue to do the best we can as a community to get this thing under control. That means wearing your mask, washing hands frequently, maintaining social distancing, and avoiding gatherings. I think that if we can do all of those things and stick with it, we're going to have a safer community… not just for our cardiac patients, but for everyone,” said Dr. Gerber.

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