The coronavirus affects not only the lungs but also the heart. This drastically increases the risk of heart attacks and strokes – even in people who have not had the disease before. The cardiologist explains what people who have contracted COVID-19 should pay attention to.
- Patients with COVID-19 often struggle with cardiovascular diseases one year after infection. According to recent studies from the USA, their risk of stroke and heart attack increases by 50 and 60 percent, respectively.
- This is often especially true of patients who were so seriously ill that they required hospitalization. However, people with moderate infections are also at risk
- Cardiologist Thomas Nordt explains what patients should pay attention to when treating an infection at home
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Author Joerg Zittlau
Joerg Zittlau, Die Welt: According to a US study, people who have had COVID-19 for a long time have an increased risk of cardiovascular disease. Even if the infection was mild. Does this coincide with what is observed in Germany?
Thomas Nordt, cardiologist: No, but this is not due to the misconceptions of the study, which is based on a very large pool of data and published in the leading journal Nature Medicine. Rather, it has to do with the fact that people in Germany who had a heart attack or stroke are now admitted to the clinic less frequently than before the epidemic. As a result, we simply lack the data to be able to confirm the observations of American researchers.
The rest of the article is available under the video.
In other words, there are more people who have left-sided chest pain, for example, but still think, “I’d rather stay home or I’ll get COVID-19 in the hospital”?
This is exactly what it is. We currently accept fewer emergency patients in both cardiology and neurology departments. In Germany, this is now a problem of greater importance than the actual increase in cardiovascular disease caused by COVID-19.
Nevertheless, these increases can actually also occur in our country?
Definitely yes. As I said, the US study was conducted correctly and is based on a very large pool of data. I assume that his results can be transferred one to one also to Germany.
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Why can a virus attacking the respiratory system have such a profound and lasting effect on the heart and circulatory system?
The authors of the study leave this issue open. It should also be said that this has not yet been finally clarified and it will be difficult to find such an explanation. Not only because the increased risk is related to diseases as diverse as heart attacks and strokes, as well as myocarditis and arrhythmias. There are theories that chronic inflammation persists after COVID-19 or that the immune system is overactive, leading to cardiovascular disease.
Are there any risk groups, i.e. people at high risk of developing heart disease after COVID-19?
If someone has already had a heart attack, they obviously have a higher risk of another heart attack. Likewise, people who have had diabetes and high blood pressure for many years – they too are more at risk. The bad thing about COVID-19, however, is that it increases the risk of cardiovascular disease even in people who have not been exposed to it before. The lower their risk increases to a greater one, and in the case of an already increased risk, it increases to an even higher one. And, as the study once again confirmed, the fact remains that originally healthy people can also develop cardiovascular disease as a result of an infection. It’s disturbing and we don’t know where it comes from.
If nothing else is known about it, it also means that there is nothing you can do to protect yourself after an infection, right?
The study authors recommend a more detailed than usual monitoring of the cardiovascular system of patients recovering from COVID-19. That’s all there is to it.
Do cardiovascular diseases have to be treated differently than usual if they arise from long covid?
Not. While we cannot explain their exact causes, we cannot treat them in any special way either. A patient with a heart attack after COVID-19 is treated in the same way as any other patient with a heart attack.
In the American study, only data from patients infected with the Alpha or Delta variants were analyzed. Can these results also tell us to some extent about the impact of the Omikron variant in this respect?
It can be assumed that this variant will be similar. On average, Omikron infections appear to be more moderate in severity, but we already know that such milder infections can also lead to cardiovascular disease in the following months.
You said that people in our country, because of fear related to an epidemic, are less likely to go to the hospital, for example in a situation where they feel chest pain. As a result, some heart attacks go undiagnosed. Does this mean that a wave of diagnoses of new heart attacks is to be expected in the near future? When people are no longer afraid of going to the doctor? And that this wave, along with the COVID-19 heart attacks, will pile up to enormous proportions?
No, I don’t expect anything like this. But we’ll be discovering traces of silent heart attacks more often. It will be more common for a patient to come to a cardiologist because of a medical condition and then it will turn out that he or she has signs of a heart attack.
So the patient may not even notice that he has had a heart attack?
Yes. It is assumed that about one-third of heart attacks are almost asymptomatic. It is often the case that when you ask the patient about it directly, he remembers that there was a moment when he felt pressure in his chest and he was short of breath, but he did not go to the doctor because the same thing passed. And I think we’ll be hearing more about these cases soon, because it’s just that people went to the doctor less often during the pandemic. (…)
Can such a late MI still be treated?
The closed coronary artery can still be opened, but this is no longer of any importance to the dead heart muscle behind it. This can’t be fixed anymore. But there is something that can still be done: cure heart failure. And it makes no difference whether it happened because of COVID-19 or not.
Professor Thomas Nordt is the medical director of the Cardiovascular Diseases Clinic of the Stuttgart clinic and a member of the Scientific Advisory Board of the German Heart Foundation.
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