A Heart Attack No It Was The Coronavirus
Cardiologists are seeing infected patients whose worst symptoms are not respiratory, but cardiac.
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By Gina Kolata
The 64-year-old patient arrived at a hospital in Brooklyn with symptoms looking like those seen in patients having a serious heart attack.
An electrocardiogram revealed an ominous heart rhythm. The patient had high blood levels of a protein called troponin, a sign of damaged heart muscle. Doctors rushed to open the patients blocked arteries but found that no arteries were blocked.
The patient was not having a heart attack. The culprit was the coronavirus.
The Brooklyn patient recovered after 12 days in the hospital and is now at home. But there have been reports of similar patients in the United States and abroad, and the cases have raised troubling questions for doctors.
What should doctors do these days when they see patients with apparent heart attacks? Should they first rule out coronavirus infection or is that a waste of valuable time for the majority of patients who are actually having heart attacks?
Should every coronavirus patient be tested for high blood levels of troponin to see if the virus has attacked the heart?
I dont know what the right answer is, said Dr. Nir Uriel, a cardiologist at Columbia University and Weill Cornell Medicine in New York.
What Is The Link Between Covid
COVID-19 can lead to many fatalities. As per an expert, here is the link between this infection and a heart attack. Read on.
The death rate and number of Covid positive cases are increasing everyday worldwide. In India, public healthcare system got crashed a few weeks ago. And since then, people are grasping for important medical facilities such as oxygen cylinders, ICU beds and ventilators. Amid the surge in COVID-19 cases, many states in the country have imposed partial lockdown. The severe illness due to Covid does not only affect your physical health but also leaves a negative impact on the mental state of an individual. It is important to uplift your mood and avoid taking stress as much as possible.
Some complications of this infection can prove to be fatal for patients. Heart health has a link with COVID-19 as observed in many cases by the doctors. Heart problem is surely a risk factor behind serious Covid symptoms. Even a heart attack can be triggered due to the effects of this virus. To clear the air, Onlymyhealth editorial team spoke to Dr. Praveen Chandra, Chairman – Interventional & Structural Heart Cardiology, Interventional Cardiology, Heart Institute, Medanta – The Medicity, about the link between Covid-19 and a heart attack.
Are The Vaccines Safe For People With A History Of Heart Disease Heart Attack Or Cardiovascular Risk Factors
Not only are the vaccines safe for people with a history of heart disease, they are essential. People with heart disease are at increased risk of severe complications from COVID-19.
On January 15, 2021, the American Heart Association released a statement urging all eligible individuals to get vaccinated to keep themselves, their family and their community healthy and safe:
As a science-based organization committed to health equity, we are heartened that COVID-19 vaccines have been approved to protect individuals, their loved ones and their communities from the pandemic. The American Heart Association which has been carefully tracking COVID-19 and its disproportionately negative effects on older adults people with underlying medical conditions and Black, LatinX and American Indian/Alaska Native people strongly encourages everyone to get vaccinated with any approved COVID-19 vaccine as it is available.
In particular, people with cardiovascular risk factors, heart disease, and heart attack and stroke survivors should get vaccinated as soon as possible because they are at much greater risk from the virus than they are from the vaccine.
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What Should You Do
Everyone needs to take precautions to prevent coronavirus. People with high blood pressure and other health conditions need to be extra careful.
The CDC offers this advice:
- Make sure you have enough medicine on hand to treat high blood pressure and other health conditions.
- Stock up on over-the-counter medicines to treat a fever and other symptoms if you get sick.
- Stay at home and limit contact with other people as much as you can.
- Avoid crowds and anyone who looks sick. Wear a face mask if you have to be in a public place where you cant stay at least 6 feet away from others.
What About The Delta Variant Do The Vaccines Protect Against Delta
Like all viruses, the virus causing COVID-19 mutates frequently. These variants may differ in their ability to infect, trigger an immune response and induce illness.
The delta variant is one of the more recent strains of the virus causing COVID-19. It is even more contagious than earlier strains, causing a new surge in cases especially among the young.
Whether our current COVID-19 vaccines can sufficiently protect against the delta variant has been a concern. However, the current data are reassuring. We strongly advise you to get one of the available COVID-19 vaccines.
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Strokes And Other Concerns
The paper also notes that COVID-19 and other diseases that cause severe inflammation throughout the body increase the risk that fatty plaque built up in the blood vessels will rupture, leading to heart attacks and stroke. Influenza and certain other viruses have been associated with increased risk of plaque ruptures within the first week after the disease was diagnosed, the authors state in their review of the available COVID-19 medical literature.
Finally, the authors describe potential drug interactions in COVID-19 patients. For example, the highly publicized malaria drug hydroxychloroquine can interact with medications designed to regulate heart rhythm, in addition to causing heart damage and worsening cardiomyopathy. Remdesivir, an antiviral that is the only COVID-19 treatment authorized by the FDA, can cause low blood pressure and abnormal heart rhythm. Its important for doctors to bear these interactions in mind when treating patients with COVID-19, the authors note.
As we gain more experience with this new pathogen, we realize that its adverse impact extends beyond the respiratory system, Brady said. We will continue to learn more about COVID-19 and the most optimal means of managing its many presentations.
Q: Why Does Heart Disease Increase A Person’s Risk Of Severe Infection
Dr. Trachtenberg: For most people, COVID-19 is a mild illness that can be managed at home. Somewhere around 20% of infected individuals, however, develop severe symptoms and complications that increase the likelihood of hospitalization, and even death.
Of those who are more at risk for severe COVID-19 are individuals with pre-existing cardiovascular conditions, including:
- Heart failure
- Cardiomyopathy
- Obesity
In addition, individuals may also be higher risk if they have high blood pressure a very common condition that affects a person’s blood vessels and heart.
Initially, it wasn’t completely clear why having a heart condition makes a person more vulnerable to COVID-19. But our understanding of how this virus affects the body specifically, the heart and vascular system has grown tremendously over the last year. We now know that there are two prevailing reasons that heart disease is associated with a poorer COVID-19 prognosis.
First, a person with a weakened heart or vascular system is more vulnerable to the complications that can develop while ill with COVID-19. These complications include:
- Low blood pressure
- Heart rate changes that accompany fever
- Excessive inflammation
- Increased risk of blood clots
Even a healthy heart has to work very hard to help overcome these COVID-19-related complications, but for a heart that’s already struggling these complications can easily become severe and turn deadly.
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Watch For Emergency Warning Signs
Seek immediate medical attention if you develop emergency warning signs for COVID-19, including:
- Difficulty breathing or shortness of breath
- Persistent pain or pressure in the chest
- Bluish lips or skin
- Sudden confusion or inability to arouse
In an emergency, call 911 or head to the nearest emergency room.
Getting Help For Heart Attacks And Strokes
Heart attacks and strokes are medical emergencies that need to be addressed as soon as you recognize symptoms. Call 911 or go to an emergency room.
The stay-at-home order is an important part of limiting coronavirus spread, but it does not apply to people experiencing medical emergencies.
Outcomes for both a heart attack or a stroke are heavily tied to how quickly care is received, so do not be afraid to if you experience symptoms of either condition. Hospitals are still safe places to go for care.
Symptoms of heart attack can include:
- Chest pain or discomfort
- Feeling weak, light-headed or faint
- Pain or discomfort in the jaw, neck or back
- Pain or discomfort in one or both arms or shoulders
- Shortness of breath
Symptoms of stroke can include:
- Weakness in the face, arm or leg, especially on one side of the body
- Confusion, trouble speaking or difficulty understanding speech
- Difficulty seeing in one or both eyes
- Trouble walking, dizziness, loss of balance or lack of coordination
- Sudden severe headache with no known cause
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Heart Problems Resolve In Majority Of Kids With Covid Inflammatory Syndrome
Heart problems in children hospitalized with multisystem inflammatory syndrome an inflammatory condition triggered by COVIDwere mostly gone within a few months, a new study by researchers at Columbia University Vagelos College of Physicians and Surgeons and NewYork-Presbyterian has found.
The study published in Pediatrics about 45 MIS-C patients is the first in North America to report on longitudinal cardiac and immunologic outcomes in children hospitalized with MIS-C.
Weve learned that COVID causes a spectrum of illness in children. Some are asymptomatic or mildly symptomatic and a small number of kids who develop MIS-C become critically ill, requiring admission to the ICU, says Kanwal M. Farooqi, MD, assistant professor of pediatrics at Columbia University Vagelos College of Physicians and Surgeons and first author of the study. It is a relief that this study shows that most of the severe heart and immunologic manifestations we saw in kids with MIS-C resolved rapidly.
MIS-C is a rare condition triggered by SARS-CoV-2 infection that causes widespread inflammation throughout the body. Many children with MIS-C were asymptomatic or had mild COVID symptoms at first but weeks later developed a variety of nonrespiratory symptoms including abdominal pain, skin rashes, heart abnormalities, and, in some cases, vasodilatory shock .
Would A Vaccine Booster Shot Help People With A Heart Condition
Many vaccines require booster shots, sometimes every year, so it is possible that we will require a new dose of the current or new COVID-19 vaccines. As of now, booster shots have been authorized for emergency use by the Food and Drug Administration and recommended by the Centers for Disease Control and Prevention only for individuals with weakened immune systems who may have had a reduced response to the initial treatment. It is possible that in the future, this authorization will be expanded for everyone or for people with other medical conditions, such as heart disease.
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Is Risk Still High After Covid
We are still collecting information, said Dr. Teleb. And we will be for years. Its obvious that risk for stroke is higher during and immediately after recovery. But long-term effects related to stroke will take longer to verify. What we do know is that rapid and early detection of stroke symptoms as well as understanding the subtle warning signs and symptoms of a stroke is vital. Remember to B.E. F.A.S.T.
- Balance: Sudden loss of balance or coordination.
- Eye: Sudden trouble seeing out of one or both eyes.
- Face: Is the face drooping or is it numb? When you smile, is it uneven or lop-sided?
- Arm Weakness: Is one arm weak or numb? Raise both arms does one drift down?
- Speech: Is speech slurred? Is the person unable to speak or difficult to understand when asked to repeat a simple sentence?
- Time to call 9-1-1: If any of these symptoms are present, even if they go away, its time to call 9-1-1 and get to a hospital immediately.
What You Need To Know
- Cases of myocarditis reported to the Vaccine Adverse Event Reporting System external icon have occurred:
- After mRNA COVID-19 vaccination , especially in male adolescents and young adults,
- More often after the second dose
- Usually within several days after vaccination
Both myocarditis and pericarditis have the following symptoms:
- Chest pain
- Shortness of breath
- Feelings of having a fast-beating, fluttering, or pounding heart
Seek medical care if you or your child have any of these symptoms, especially if its within a week after COVID-19 vaccination.
If you have any health problems after vaccination, report them to VAERSexternal icon.
Healthcare Providers: For additional recommendations and clinical guidance, visit Clinical Considerations: Myocarditis after mRNA COVID-19 Vaccines | CDC
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Cases Mostly In Males Under 30
Tom Shimabukuro, MD, MPH, MBA, the deputy director of the Immunization Safety Office at the CDC, said the agency has received reports of 1,226 cases of myocarditis, with 827 reported after dose two of either the Moderna or Pfizer vaccine.
Of those cases identified after second doses, 563 followed the Pfizer vaccine series. In total, that’s approximately 12.6 heart inflammation cases per million doses administered in the United States.
Among the 1,226 patients, 484 are younger than 29, and roughly two-thirds are men.
A major talking point through the ACIP meeting was that only Pfizer is approved for emergency use in the United States for teens ages 12 to 18. For this age-group, adenovirus-based vaccines, such as Johnson & Johnson, are not currently available.
Doran Fink, MD, PhD, deputy director-clinical, division of vaccines and related products applications at the Food and Drug Administration , said the agency would add warnings about the rare side effects on Moderna and Pfizer fact sheets. The CDC also said patients who develop heart inflammation after a first dose of mRNA should wait until their inflammation heals before getting a second dose, and should talk to their care providers.
What If A Family Member Develops Symptoms
Take the following precautions if a family member shows symptoms of flu or COVID-19:
- Wash your hands often, and make sure your family member does the same.
- Keep surfaces in your house clean.
- Maintain a safe distance, if possible, by staying apart if you live in the same home oSleep in different rooms. oDont eat at the same table. oDont share utensils.
Have a candid discussion with your family about the risks if someone becomes infected. Emphasize how important it is to maintain a safe distance and keep the house sanitized.
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High Blood Pressure Risks
Growing data shows a higher risk of COVID-19 infections and complications in people with high blood pressure.
Analysis of early data from both China and the U.S. shows that high blood pressure is the most commonly shared pre-existing condition among those hospitalized, affecting between 30% to 50% of the patients. Other health conditions included cancer, diabetes, or lung disease. In Italy, a report said that more than 99% of people who had died from the virus had one of these conditions — and 76% of them had high blood pressure.
Other research shows that people with high blood pressure are also slightly more likely to die from coronavirus. Their risk is about twice as high as that of the overall population.
Should I Be Concerned About Thrombosis After Vaccination What Are The Warning Signs
Thrombosis is an abnormal clot formation that cause stroke, heart attack and other major issues. COVID-19 is associated with a very high risk of thrombosis, therefore a high risk of death.
In some very rare instances, an abnormal immune response has been associated with the COVID-19 vaccine. In those cases, the number of platelets your body manufactures goes down and a clot forms. This is very rare less than 1 in 50,000 cases, seen primarily in individuals receiving the AstraZeneca COVID-19 vaccine. This vaccine is currently not in use in the United States.
If you experience severe headache, trouble seeing, loss of strength or balance, chest pain or discomfort, nausea or vomiting in the days following your COVID-19 vaccination, it would be prudent to seek medical attention to exclude this or other rare complications of the COVID-19 vaccine.
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Heart Attacks Heart Failure Stroke: Covid
COVID-19 can cause serious cardiovascular complications, including heart failure, heart attacks and blood clots that can lead to strokes, emergency medicine doctors report in a new scientific paper. They also caution that COVID-19 treatments can interact with medicines used to manage patients existing cardiovascular conditions.
The new paper from UVA Healths Dr. William Brady and colleagues aims to serve as a guide for emergency-medicine doctors treating patients who may have or are known to have COVID-19. The authors note that much attention has been paid to the pulmonary complications of COVID-19, but less has been said about the cardiovascular complications that can lead to death or lasting impairment.
In writing this article, we hope to increase emergency physicians knowledge and awareness of this new pathogen and its impact on the cardiovascular system, said Brady, of UVAs Department of Emergency Medicine. As we encounter more and more patients with COVID-19-related illness, we are increasing our understanding of its impact on the body in general and the cardiovascular system in particular. The rate of learning on this area is amazingly rapid. Information continues to change weekly, if not daily.