It is hard to turn on the radio, your television, or browse the web and not be overwhelmed with the news and information about the coronavirus (COVID-19). As we learn more about the virus it is evident that patients with heart disease should be extra careful.
Initial studies have found that up to 40% of patients admitted to the hospital with the corona virus have cardiovascular disease. Even though the lungs are the main target of the virus, it can affect the heart as well, especially if there is underlying heart disease. The body will try to fight the virus and thereby requires the heart to pump harder. If someone already has heart problems, such as blocked heart arteries or heart failure, the body may not be able to provide the extra heart function needed to fight the virus.
In patients with coronary artery disease (blocked heart arteries), the fatty build-up in the arteries can become unstable during a viral illness and eventually lead to an acute heart attack. It is important to bring awareness that chest pain should always be immediately evaluated by your physician or in the emergency room.
Recent reports have shown that the fear of the coronavirus has kept more than half of patients with a heart attack away from the hospital. Other reports have demonstrated an increase in the number of out-of-hospital cardiac arrests which is likely related to patients staying at home with symptoms. Therefore, it is of utmost importance to have your symptoms evaluated promptly.
Finally, some patients who present with COVID-19 have new reduced heart function. Recent research has shown that the virus is not only present in the lungs but can also infiltrate the heart muscle. This can lead to inflammation of the heart muscle, which is called myocarditis. Some of these patients might need temporary support with a mechanical device to allow for the heart to recover from the insult. We are still learning whether the effects of the coronavirus on the heart are reversible or whether there is some degree of permanent damage to the muscle. However, in otherwise healthy individuals, severe damage to the heart from the virus is likely rare.
People with known heart disease should stay in close contact with their doctor during the pandemic and make sure to continue their heart medications unless otherwise instructed by their physician. If they were infected with COVID-19, they should have a follow-up examination after they recover to evaluate for any further heart damage from the virus.
Lowie Van Assche, M.D., FACC, is an interventional and structural heart disease cardiologist with the My Cardiologist group serving the South Florida community. In addition to managing general adult cardiac conditions, he specializes in coronary artery disease (blocked heart arteries) and valvular heart disease (transcatheter aortic valve replacement, transcatheter mitral valve repair). He has published numerous articles and book chapters, and presented at both national and international meetings.