- Doctors think the novel coronavirus might affect the heart directly in some COVID-19 patients.
- The virus might be damaging the heart even in patients who do not suffer from heart disease.
- In some cases, patients were rushed to the emergency room with a heart attack diagnosis, but they turned out to be infected with the coronavirus.
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If you are rushed to the emergency room after experiencing what you thought was a heart attack, it turns out that it may have been the novel coronavirus. COVID-19 is a respiratory disease, with the virus primarily targeting the lungs. That’s why the most common symptoms include fever, cough, sore throat, and difficulty breathing. But the longer this goes on, the more we learn about the virus.
Some patients may display early warning signs of COVID-19, like the loss of smell and/or taste. Others may come to the hospital with neurological warning signs. And doctors now think that some patients might be predisposed to heart damage after infection, which could be fatal.
With most medical conditions, it’s the heart giving out that ultimately kills you. The same goes for severe COVID-19 cases that spiral out of control. People will focus on sepsis and severe respiratory problems that can’t be corrected with ventilators and other treatments. But once the heart stops, recovery is unlikely. That’s not just because of the severity of the illness, but also because of logistic reasons that might delay the response to patients who code.
However, an increasing number of doctors believe that not all COVID-19 patients will show signs of heart damage due to pulmonary failure and inflammation. The virus might infect the heart muscle directly.
Data from China, Italy, and the US shows that this is the case for a subset of patients. KHN explains that an initial study found cardiac damage in as many as 1 in 5 patients, which resulted in heart failure and even death. It happened in patients who didn’t show any signs of respiratory distress, not just in critical cases.
Two studies from China also looked at cardiac problems in COVID-19 patients. The larger of the two looked at 416 hospitalized patients, concluding that 19% showed signs of heart damage, and they were more likely to die. 51% of people with heart damage died, versus 4.5% of those who didn’t. What’s more troubling is that patients who didn’t have any preexisting heart conditions but developed heart damage during the infection were more likely to die than patients with known heart disease but no heart damage due to COVID-19.
Cardiologists have yet to explain why some patients might be predisposed to develop cardiac damage, but they’re looking at the matter. “We have to assume, maybe, that the virus affects the heart directly,” Dr. Ulrich Jorde said. “But it’s essential to find out.” Jorde is the head of heart failure, cardiac transplantation, and mechanical circulatory support for the Montefiore Health System in New York City.
Exploring the heart condition of COVID-19 patients showing severe symptoms can be problematic for various reasons. First of all, these patients can’t undergo invasive procedures such as heart biopsies. Secondly, it’s a risk for physicians in hospitals where personal protective equipment (PPE) is lacking. KHN reports that many hospitals don’t even use electrocardiograms on patients in isolation to avoid exposing additional staff to the virus.
These heart-related findings forced some emergency rooms to reconsider how they handle potential heart attacks. Current protocols include a rapid response that involves rushing the patient to catheterization labs to clear the blockage of blood vessels. But doctors have now discovered patients who experience heart attack symptoms because of COVID-19, not because their arteries are blocked.
“We’re taking a step back from that now and thinking about having patients brought to the emergency department so they can get evaluated briefly so that we could determine: Is this somebody who’s really at high risk for COVID-19?” Columbia University Irving Medical Center interventional cardiologist Dr. Sahil Parikh told KHN. “And is this manifestation that we’re calling a heart attack really a heart attack?”
While COVID-19 mostly kills older people and patients who suffer from other ailments, we’ve seen plenty of exceptions to these rules that can’t always be explained. Young children, teens, and young adults have died of COVID-19 in the past few weeks. It’s unclear whether their hearts were damaged by the virus.
Understanding how the virus attacks the heart is critical and could help doctors save more patients in the future. COVID-19 survivors will also have to have their heart condition checked, and treat any potential heart problems that may be caused by the COVID-19 infection.