A lot has been learned about COVID-19 in the last year, but some things remain to be seen, such as the many effects the virus can have on the heart.

Dr. Teresa Daniele, chief of cardiology, UCSF Fresno, says she’s seen both direct and indirect short-term effects on heart health, but more studies are needed to understand the long-term effects of COVID-19.
 

An increase in inflammation and clotting

One effect Dr. Daniele has seen is a condition called myocarditis, which is an inflammation of the heart that’s typically caused by a viral infection, like the coronavirus. This inflammation can cause weakness to the heart muscle, scar tissue formation and life-threatening arrhythmias (abnormal heart rhythms).

Severe myocarditis prevents the body from getting enough of the blood it needs, which can lead to the formation of clots, resulting in a stroke or heart attack.

Inflammation has also been observed in the pericardium — the membrane that surrounds your heart — as well as in the lining of blood vessels. As with myocarditis, inflammation in the blood vessels can lead to clots in the legs, lungs and arteries, increasing risk of heart attack.

Even those with a milder case of the virus are experiencing adverse effects on their heart health.

“The other thing we're seeing in the hospital is, even if you have mild symptoms, almost all the patients have some degree of muscle damage, and we can see that in bloodwork that we do,” says Dr. Daniele.

It’s unclear how extensive the heart muscle damage is, or what lasting effects it will have. “Some we know because their heart muscles are weakened, and some we don't know. They ultimately look OK on a routine ultrasound, but the long-term effects of scarring and so forth — we just don't know yet,” she says.
 

Fear of COVID-19 can cause irreversible harm

One indirect effect COVID-19 is having on heart health is tied to fear of the virus itself. Those experiencing symptoms of heart problems may avoid getting the help they need for fear of coming into a hospital or doctor’s office where they may come into contact with a person sick with COVID-19.

“Patients are afraid — they don't want to come to the emergency department, they don't want to seek medical attention, because they're afraid of actually getting exposed to the virus in the emergency room or in the hospital,” says Dr. Daniele. “And as a consequence, we're having patients coming in weeks later with severe, irreversible damage to their heart muscle.”

Drenda Montgomery, R.N., knows firsthand how dangerous ignoring heart health symptoms can be. Montgomery is director of cardiovascular services at Community Medical Centers — and she’s had three heart attacks of her own.

She shares how early in the pandemic, there were patients who stayed away from the hospital because they were afraid of contracting the virus.

“And then when they did finally get so sick that they came in, we couldn't save them. We were losing patients at a higher rate for illnesses that we could have treated had they come in earlier.”

Although COVID-19 restrictions across the state and country seem to be relaxing, safety measures continue to be taken at Community Medical Center facilities, including:
 

• Personal protective equipment (PPE) such as masks, eye shields, gloves and gowns that are worn by all caregivers and changed before and after each patient is seen

• Separation and quarantining of COVID-19-positive patients or those suspected of having COVID-19 from non-COVID-19 patients to prevent cross contamination

• Masking of all patients and visitors

• Negative air flow handling systems that prevent air from COVID-19-positive patients from circulating to other areas in the hospital
   

Montgomery implores patients to see their doctor as soon as possible, and not let fear of COVID-19 lead to a potential life-threatening emergency.
 

Vaccine safe for those with heart problems

If fear of the virus is keeping you away from seeking medical attention, one thing you can do to help protect yourself is get the COVID-19 vaccine. The vaccine has been proven to be safe for most people — the exception being those who have had severe anaphylactic reactions to other vaccines.

Patients who take blood-thinning medication, or who have conditions such as diabetes or heart disease, or have suffered a stroke, may have concerns about safety in taking the vaccine. But these are exactly the people Dr. Daniele says should get the vaccine.
They are at the highest risk of having long-term effects if they contract the virus, including an increased chance of death.

“The people who are worried — because they have problems — about the vaccine” says Dr. Daniele, “are really the people who would benefit the most from the vaccine.

“So absolutely anyone who has cardiovascular disease, heart attacks, strokes, especially overweight, diabetes, hypertension and immunocompromised … Those are all the patients that are very high risk, and would absolutely benefit from the vaccine.”

Dr. Daniele says while the virus has taken a mental toll on many, it’s important to stay the course. Continue to wear a mask, wash your hands frequently and stay six feet or more away from others — even after you receive the vaccine.

“We have to unite as a community, we have to look out for one another,” she says. “This is not a sprint; this is a marathon.”