Last week, 3 years ago, our president declared a disaster state and locked us down for 21 days. Many people contracted COVID, some of them tragically passed away. Some patients recovered completely from the infection with no lasting symptoms.
Unfortunately, others suffered and are still suffering from what we call long COVID syndrome.
At least 17 million people in the WHO European region experienced long COVID in the first two years of the pandemic; millions may have to live it for years to come.
Many of the “long haulers” experiences heart symptoms like palpitations, dizziness, chest pain, shortness of breath, tightness of chest, tachycardia, and blood pressure regulation problems.
Why did these patients’ hearts get affected and damaged?
Temporary or lasting damage to heart tissue was due to several factors:
Lack of oxygen.
As the virus caused inflammation and fluid to fill up the air sacs in the lungs, less oxygen reached the bloodstream. The heart had to work harder to pump blood through the body, which was especially dangerous in people with pre-existing heart disease. Some hearts failed from overwork, or insufficient
oxygen that caused cell death and tissue damage in the heart and other organs.
Myocarditis: inflammation of the heart.
The coronavirus infected and damaged the heart’s muscle tissue directly, as is possible with other viral infections, including some strains of the flu. The heart also became damaged and inflamed indirectly by the body’s own immune system response, called the cytokine storm.
Coronavirus infection also affected the inner surfaces of veins and arteries, which caused blood vessel inflammation, damaged small vessels and blood clots, all of which compromised blood flow to the heart or other parts of the body.
COVID infection also caused cardiomyopathy, a heart muscle disorder that affected the heart’s ability to pump blood effectively. When the virus attacked, the body underwent stress and released a surge of chemicals called catecholamines, which stunned the heart.
Most serious of all, was the immune system that launched an attack on the invading virus that was so severe that it destroyed healthy tissues.
When responding to infection with the coronavirus, the body released a flood of proteins called cytokines that helped cells communicate with one another and fight the invaders.
In some people, perhaps due to a genetic difference, this normal defensive event was exaggerated, leaving them vulnerable to a cytokine storm. In this cytokine storm, the immune system response causes inflammation that overwhelmed the body, destroying healthy tissue and damaging organs such as the kidneys, liver and heart.
The cytokine storm and its resulting heart damage also affected the heart’s rhythm. Serious ventricular arrhythmias due to a cytokine storm was for some patients catastrophic. The cytokine storm was difficult to survive.
The damage for this immune reaction is a complicated problem and is probably the cause of residual inflammation in the cardiovascular system that cause long- haul COVID cardiac symptoms.
There are currently treatments that can improve and hopefully in the long-term cure this conditions. As time goes on, I am sure more therapies will come to light. For now, it is a relief to know that we need not be despondent about this conditions, since alternative and functional remedies and medicines can assist favourably.
Often the body just needs assistance to heal and bring the body back into homeostasis. For more information on how we can assist you, please contact the practice on 012 460 9216.
Heart Rate and COVID-19
After you have had COVID-19, if you are experiencing a rapid heartbeat or palpitations, you should contact your doctor. A temporary increase in heart rate can be caused by a lot of different things, including dehydration. Make sure you are drinking enough fluids, especially if you have a fever.
Symptoms of a rapid or irregular heart rhythm may include:
How can I tell if I have developed a heart problem after COVID-19?
In some people, heart rates can vary from fast to slow, unrelated to exertion, for no apparent reason.
But, Post says, shortness of breath, chest pain or palpitations after having COVID-19 is a common complaint. “Any of these problems could be related to the heart, but they could also be due to other factors, including the aftermath of being very ill, prolonged inactivity and spending weeks convalescing in bed.”
Shortness of Breath
“You want to consult a doctor if any of your symptoms are severe, especially shortness of breath,” Post says. She recommends using a commercially available O2 (oxygen) saturation monitor.
“Shortness of breath by itself is not always a sign of a serious problem, but if you have that symptom along with low O2 (below 92%), that is a reason to be concerned.” Sometimes people are short of breath with exertion after COVID-19 because they have been less active for a long time and need to gradually build their fitness level back up.
A diagnosis of heart failure after COVID-19 is rare. But if you have shortness of breath or leg swelling after COVID-19, you should contact your doctor, who may recommend evaluation by a cardiologist if tests indicate you are at risk.
COVID-19 Chest Pain
What about lingering chest pain, another common post-COVID complaint? “Chest pain may be nothing serious, but if you are having severe chest pain, get help, especially if it is persistent or if you are also having nausea, shortness of breath or lightheadedness: These could be symptoms of a heart attack.”
“If you have chest pain when you inhale, you might have lung inflammation. Sudden, severe chest pain could be a blood clot in the lung (pulmonary
embolism),” Post says.
People recovering from the coronavirus sometimes show symptoms of a condition known as POTS (postural orthostatic tachycardia syndrome). Researchers are exploring whether or not there is a link.
POTS isn’t directly a cardiac problem, but a neurologic one that affects the part of the nervous system that regulates heart rate and blood flow. The syndrome can cause rapid heartbeats when you stand up, which can lead to brain fog, fatigue, palpitations, lightheadedness and other symptoms.
Can COVID-19 symptoms mimic a heart attack?
Yes. People with COVID-19 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. But often when these patients are given an angiogram, there is no evidence of a major blockage in the heart’s blood vessels, which would indicate a heart attack in progress.
Symptoms of myocarditis can also mimic those of a heart attack. Also, viral infections such as COVID-19 can cause very small blood clots to form, which can block tiny blood vessels and cause pain.
People with signs and symptoms of a heart attack should seek urgent medical attention and not manage these symptoms at home.
Dr. Marike de Klerk