Accessed May 4, Ammirati E, et al. Management of acute myocarditis and chronic inflammatory cardiomyopathy. Etiology and pathogenesis of myocarditis. Siripanthong B, et al. Recognizing COVID—related myocarditis: The possible pathophysiology and proposed guideline for diagnosis and management.
Heart Rhythm. Ferri FF. In: Ferri's Clinical Advisor Elsevier; Treatment and prognosis of myocarditis in adults. Allan CK, et al. Clinical manifestations and diagnosis of myocarditis in children. Bonow RO, et al. Healthy habits to help prevent flu. Centers for Disease Control and Prevention. Cooper LT, et al. Michos says people with COVID can have symptoms similar to those of a heart attack, including chest pain, shortness of breath and changes on their echocardiogram ultrasound of the heart , or EKG.
Symptoms of myocarditis can also mimic those of a heart attack. Additionally, Michos says that viral infections such as COVID can cause very small blood clots to form, which can block tiny blood vessels and cause pain. She notes that before the coronavirus pandemic, patients with these signs and symptoms might go directly to the catheterization lab for treatment. However, Michos stresses, even in the pandemic, real heart attacks can still occur, and patients with signs and symptoms of a heart attack should still seek urgent medical attention and not manage these symptoms at home.
Michos says that people living with heart disease should stay in close touch with their doctors during the pandemic, and take care to comply with medication to manage their heart condition. If they catch COVID, they should request a follow-up examination after they recover to detect any further heart damage from the virus.
Patients without known heart disease who get COVID should follow up with their primary care doctor. Tests may be recommended if symptoms such as weakness, shortness of breath or chest pain persist after recovery, since these problems could be due to COVIDrelated damage to the lungs or heart. Viral infections of the heart are not uncommon.
Some resolve on their own, especially in healthy individuals, and leave no lasting problems behind. In other patients, the viral infection causes inflammation , and this damages the muscles in the heart, causing viral cardiomyopathy.
Most commonly, viral cardiomyopathy presents as a form of dilated cardiomyopathy, where the chambers of the heart enlarge and the heart has to work harder to pump blood throughout the body. The initial viral infection may not cause symptoms, or it may lead to symptoms so mild the patient never seeks treatment.
Studies performed in the months after people developed even mild cases of COVID have found that the cardiac fallout from the virus may be long term or permanent for some. Long COVID symptoms like shortness of breath and chest pain are well documented, but experts suggest that long-haulers —those who experience long-lasting effects after an illness—may even be affected by more serious complications, such as chronic inflammation and new heart dysfunction.
These complications can lead to a new diagnosis of heart failure or cardiomyopathy in people who have had COVID or can worsen existing heart conditions in those who already have them. Some researchers have even suggested that cardiomyopathy and heart failure may be the natural result of COVID rather than a rare complication. Since the pandemic started, many people have experienced stress from quarantine, worries about getting sick, political tension, job loss, and more.
Some evidence has suggested that this strain is leading to some cases of a rare form of cardiomyopathy called Takotsubo syndrome, or stress cardiomyopathy. Sometimes referred to as broken heart syndrome , this condition occurs after an extremely stressful physical or emotional event. It causes weakness on the left side of the heart, which pumps blood out to the body.
Some of these cases were traced to the havoc that the virus wreaks inside the body, but a large number developed in people who had tested negative for COVID Certain groups of people are at higher risk of experiencing stress cardiomyopathy, including postmenopausal women and people with existing mental health challenges. Treatment for cardiomyopathy primarily focuses on improving the heart's ability to pump blood to areas of the body that are damaged, preventing complications like fluid buildup and treating other adverse effects of poor heart function.
Some medications frequently prescribed for cardiomyopathy include:. Because these medications will not increase a person's risk of contracting COVID or of experiencing severe symptoms if they do become sick, they are safe to take.
Do not stop or change the dosage of your heart medications without consulting your healthcare provider first. Implantable pacemakers or defibrillators also may be recommended to help the heart function better. However, these forms of treatment are invasive, and these devices, which can be monitored virtually through telehealth , can pose complications in people with cardiomyopathy and heart failure. If you have a pacemaker or defibrillator, you most likely already take a medication that helps prevent blood clots from collecting around the device.
Since the risk of blood clots increases during a coronavirus infection, be sure to continue taking the anticoagulant medications your healthcare provider has prescribed. Some over-the-counter OTC medications—especially ones used to treat the symptoms of COVID—can be dangerous to people with certain heart conditions or who are taking other medications. Certain decongestants or cold medicines, for instance, can change your heart rhythm. Be sure to talk to your healthcare provider about what OTC medications you can take or should avoid if you have cardiomyopathy.
It's not only safe to get one of the vaccines approved to prevent COVID, it's also highly recommended. While the vaccines are new and there is some risk of side effects or rare reactions, the immunity benefits are viewed as outweighing any vaccination risks. The novel coronavirus affects heart and lung tissue and can cause permanent damage to these organs.
As more information becomes available on the long-term consequences of COVID infection, it's become clear that survivors may have lifelong cardiovascular hurdles to overcome. There also has been evidence that some people who become severely ill with COVID go on to develop Takotsubo syndrome, or stress cardiomyopathy.
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