Coronavirus gets its name from its distinctive structure. SARS coronavirus Cov-2 causes COVID-19 disease, which is a syndrome of symptoms. Symptoms can be complex, and the course of the disease can range from asymptomatic to mild to severe, including death.
The course of COVID-19 disease is dominated by flu-like respiratory symptoms, but symptoms from other organs are also possible, such as: heart failure, cardiac arrest, arrhythmias, cardiac ischemia or sepsis.
What can be the cardiac symptoms of severe COVID-19?
In addition to respiratory symptoms, such as respiratory failure in the course of viral pneumonia, but also cardiac complications can occur. The most severe ones are hypotonia, or low blood pressure, cardiac arrhythmias, cardiac arrest, myocarditis, heart failure or death from cardiovascular causes.
Having heart disease, am I at greater risk of coronavirus infection?
It seems that the risk of infection may be higher. It is mainly related to being with an infected person, however, there are some indications that people with weaker immunity, such as patients with diabetes or heart disease such as hypertension or heart failure, may be more susceptible to coronavirus infection. The risk of coronavirus infection and its complications are certainly higher in older patients.
There are clear data indicating that people who have chronic diseases, including cardiovascular diseases such as hypertension, heart failure or coronary artery disease, are at a higher risk of severe COVID-19.
Can certain cardiovascular drugs increase the risk of coronavirus infection and worsen the course of COVID-19 disease?
Despite existing hypotheses indicating a possible link between coronavirus infection and taking certain medications, used, for example, for hypertension, there is no evidence today to conclude unequivocally that these drugs increase the risk of infection and the severity of the course of COVID-19 disease.
How does coronavirus damage the cardiovascular system?
The adverse effects of coronavirus on the cardiovascular system are multidirectional. It can cause inflammation of the heart muscle or exacerbate adverse processes in the body, such as inflammatory processes. It can also activate the neurohormonal system and thus destabilize the cardiovascular system, resulting in coronary incidents, cardiac arrhythmias or severe heart failure.
Can coronavirus infection and a history of COVID-19 leave permanent “marks” on the heart muscle?
At the moment, the amount of research on this topic is limited, but, given the experience of observing patients who have had cardiovascular complications after another viral illness, such as the influenza virus, or in patients who have undergone severe pneumonia, it can be assumed that permanent changes in the cardiovascular system are possible. This could include the development of heart dysfunction and failure.
Having a cardiac arrhythmia, am I more likely to be infected with coronavirus and at risk of severe COVID-19?
- Rhythm disturbances alone are unlikely to predispose to an increased risk of infection, but if you are infected with coronavirus and have COVID-19 disease, your heart rhythm may accelerate and, as a result of the severity, some forms of dysfunction, such as more frequent atrial fibrillation or extra contractions.
- It has been shown that some of the drugs used to treat COVID-19 can affect the heart rhythm and cause arrhythmias. This phenomenon is currently under investigation. When these drugs are used, increased monitoring is needed, i.e. increased frequency of ECG recording and proper interpretation by the physician. In case of ECG abnormalities, the dosage or use of drugs may be modified or withheld.
Do the drugs used to treat COVID-19 affect the heart?
Drugs used in patients with COVID-19 may impinge on cardiovascular function. They can exacerbate some forms of arrhythmias, including acute cardiac arrhythmias and the risk of cardiac arrest. These are mainly used in the treatment of COVID-19 disease: antimalarials and some antibiotics, which can affect changes in ECG recordings.
How should I behave in the event of alarming cardiac symptoms?
If a patient develops cardiac symptoms during the pandemic period, such as severe chest pain, which may be due to a heart attack, or worsening heart failure (shortness of breath, swelling of the lower extremities), despite general advice, do not delay contacting medical personnel. It is necessary to act in the same way as in the absence of a pandemic. It is best to provide the patient with emergency assistance, such as an ambulance service, whose personnel will be able to assess the severity of the symptoms and their risk to the patient.
The occurrence of which cardiac symptoms suggests that I should not wait to call for help?
You should not delay seeking help in case of:
- sudden onset of a burning, persistent, chest pain,
- a sudden high rise in blood pressure,
- the onset of arrhythmias and palpitations that make you feel unwell,
- very low blood pressure,
- sudden shortness of breath,
- as well as worsening: chronic chest pain, resting shortness of breath, increased edema of the lower extremities.
It should be strongly emphasized that any patient, especially those with a previous cardiac history or a patient with cardiovascular factors, can have life-threatening cardiac symptoms independent of COVID-19. Delay in treatment can lead to serious complications.
Can COVID-19 symptoms overlap with heart disease symptoms?
It has been confirmed that similar symptoms can occur in the course of diseases, especially heart failure. These symptoms are mainly:
- dyspnea,
- deterioration of exercise tolerance,
- general weakness,
- cough.
COVID-19 and cardiovascular disease are not mutually exclusive. A patient with COVID-19 may develop worsening or new symptoms of heart failure. Therefore, it is very important to distinguish the symptoms of the diseases. It may be helpful to tele-counsel with a specialist or a general practitioner, or to relate current symptoms to similar incidents in the past. Such a situation may suggest heart failure. However, if flu-like symptoms such as fever, chills or muscle aches appear, and the patient has had recent contact with an infected person, COVID-19 may be suspected.
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