How does COVID-19 affect your heart?

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COVID-19 viruses affecting the heart, conceptual 3D illustration. Heart complications associated with COVID-19 coronavirus disease.

Over the last two and a half years of the COVID-19 pandemic, medical experts have found that the virus can cause damage to many parts of the body. Although most people experience symptoms in their nose, throat and lungs, the virus also can damage other organs, such as the heart.

“COVID-19 can cause the heart to do its job — pumping blood – less efficiently,” said Eric Stecker, an  Oregon Health & Science University cardiologist. When the heart isn’t working efficiently it can cause several  problems, including shortness of breath and irregular heartbeats.

Heart anatomy

Your heart is a fist-sized organ and the star of your circulatory system. Your circulatory system is made up of veins and arteries that carry blood throughout the body, and that blood is full of oxygen and nutrients.

Fundamentally, the heart functions as a pump. Every time your heart beats, it pumps blood in or out of the organ. When blood enters the heart, it lacks oxygen. The heart pumps blood to the lungs, where it picks up oxygen. After blood flows back into the heart from the lungs, the heart pumps that oxygen-rich blood into your arteries. The blood flows through the body, dropping off oxygen where needed, then heads back to the heart.

And the pump never stops, unless there’s a serious problem.

“If the heart stops beating, organ function ceases within minutes. Without resuscitation, that person dies,” Stecker said.

Heart damage

COVID-19 can affect the heart directly or indirectly.

  • Directly — The virus can infect heart tissue, damaging the organ itself, which can cause inflammation and chest pain. If someone is living with a heart condition, like heart disease,  arrhythmia (abnormal heartbeats) or high blood pressure, a COVID-19 infection can worsen those problems.
  • Indirectly — COVID-19 first damages other organs, such as the lungs. When someone’s lungs are damaged, they may experience shortness of breath. They may also develop pneumonia (when the lungs fill with fluid) and have trouble breathing in enough oxygen. This makes the heart  work harder to pump blood, and the extra work strains the heart.

    “When the heart works too hard, blood pressure can rise to dangerous levels,” Stecker said.

    In some cases, the body’s immune system goes into overdrive when infected with COVID-19. When you’re sick, the body sends out a small molecule called a “cytokine,” which transmits chemical messages to other immune cells, telling them what to do. In severe cases, the immune system releases too many cytokines, leading to a deadly condition called a “cytokine storm,” that can cause an inflamed heart. An inflamed heart cannot pump blood efficiently.

    COVID-19 also has caused blood clotting disorders, which strain the heart and  can lead to heart attacks, although the full relationship between COVID-19 and blood clots, is not well nderstood. Blood clots can occur with other infections, even the flu. Early in the pandemic, many patients hospitalized with COVID-19 experienced blood clots.

    “There was a concern that COVID-19 may be uniquely causing clotting disorders,” Stecker said.

    In the last two years, medical professionals have determined that COVID-19 doesn’t necessarily cause a specific clotting disorder. But Stecker believes the issue is worthy of more research.

    “There are so many people who are becoming infected with COVID-19 that there is a fair amount of blood clotting issues out there, and the magnitude of it compared to influenza and other infections still has to be studied.”
Staying safe

During and after a COVID-19 infection, pay close attention to your symptoms. Things like shortness of breath, lightheadedness, fatigue and a small amount of chest pain are normal. If these symptoms last longer than a month, Stecker suggests a checking with a health care provider.

The most effective way to keep your heart safe is to get all your recommended vaccines and boosters and wear a well-fitting mask in crowded indoor spaces, or in outdoor spaces that are so crowded they feel like indoor spaces.

“Vaccination protects against the most severe illness and damage to the body’s organs really nicely, really effectively,” Stecker said, even with subvariants like Omicron BA.4 and BA.5, which are more able to escape the immunity provided by vaccines. You may still get COVID-19, but you most likely will not experience severe disease or major organ issues.