Could Covid-19 Affect Your Risk for Heart Attack and Stroke?

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Mark Peterman, M.D., Cardiology

More than a year into the pandemic, scientists are still investigating the risks of heart damage from COVID-19. People who’ve contracted COVID-19, even if they don’t have underlying heart issues, need to know that a number of studies have found significant cardiac injury related to infection by the virus.

So it’s important to stay ahead of the heart risks if you are a COVID-19 survivor. The reason being that nearly one-fourth of those hospitalized with COVID-19 have been diagnosed with cardiovascular complications, which have been shown to contribute to roughly 40 percent of all COVID-19-related deaths.

A growing number of studies suggest many COVID-19 survivors experience some type of heart damage, even if they didn’t have underlying heart disease and weren’t sick enough to be hospitalized. This has health care experts worried about a potential increase in heart failure.

“COVID can cause a significant whole body inflammatory response that can lead to many heart issues,” says Mark Peterman, M.D., a cardiologist at HeartPlace Plano West and a physician on the medical staff at Texas Health Presbyterian Hospital Plano. “Arrhythmias, fluid around the heart, weakening of heart muscle and even heart attacks are all potential concerns.”

Two studies suggest how widespread heart damage may be. In the Journal of the American Medical Association Cardiology, an analysis of autopsies done on 39 COVID-19 patients identified infections in the hearts of patients who had not been diagnosed with cardiovascular issues while they were ill.

Another JAMA Cardiology study used cardiac MRIs on 100 people who had recovered from COVID-19 within the past two to three months. Researchers found abnormalities in the hearts of 78 percent of recovered patients and “ongoing myocardial inflammation” in 60 percent. The same study found high levels of the blood enzyme troponin, an indicator of heart damage, in 76 percent of patients tested, although heart function appeared to be generally preserved. Most patients in the study had not required hospitalization.

Dr. Peterman cautions that COVID-19 is a difficult disease to predict for heart patients and others. “Prevention is the surest way to stay healthy, and that means vaccination, maintaining a healthy weight and regular exercise,” he says.

Whether screenings to detect cardiovascular damage should become a routine part of follow-up care for COVID-19 patients remains unclear, according to researchers.

If you are recovering from COVID-19, watch for the following symptoms — and consult your physician if you experience any of them:

  • Increasing or extreme shortness of breath with exertion
  • Chest pain
  • Swelling of the ankles
  • Heart palpitations or irregular heartbeat
  • Lightheadedness or dizzy spells

If you are a heart patient, you should continue taking your usual medications, such as ACE inhibitors and angiotensin receptor blockers, which are used to treat conditions such as high blood pressure and heart failure.

 

COVID-19 and Stroke Risks

Analysis of data from the American Heart Association’s COVID-19 CVD Registry of more than 20,000 U.S. adults hospitalized with COVID-19 through November 2020 found that, overall, COVID-19 patients had an increased risk of stroke compared with patients who had influenza or sepsis. COVID-19 patients with ischemic stroke were also more likely to be older, male, Black or have high blood pressure, Type 2 diabetes or an irregular heartbeat.

“Identifying the preventable factors that can put you at an increased risk for a stroke can empower you to reduce your likelihood for a stroke after a COVID-19 diagnosis,” said Claudia Perez, M.D., a neurologist on the medical staff at Texas Health Harris Methodist Hospital Fort Worth.

Independent of COVID-19, high blood pressure, diabetes and irregular heartbeats (such as atrial fibrillation) all increase stroke risk. High blood pressure is a leading risk factor for stroke. Diabetes increases the risk of ischemic stroke (clot caused) for people of all ages. And atrial fibrillation increases a person’s risk for stroke by up to five times. If you have any of these conditions, you should continue to take your usual medications to manage your disease progression and reduce your risk of stroke.

“You can also implement lifestyle changes like not smoking, eating healthy and staying active,” Dr. Perez said. “This not only reduces your risk for a stroke but can also reduce the need for medications.”

If you’ve had COVID-19 and recovered, or know someone who has, and are concerned about future health risks, discuss your concerns with your physician. Or, find a heart and vascular specialist today.

Texas Health Physicians Group providers are employed by Texas Health Physicians Group and are not employees or agents of Texas Health Resources hospitals.

Doctors on the medical staffs practice independently and are not employees or agents of Texas Health hospitals or Texas Health Resources.

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