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COVID 19 and Heart Disease

Heart disease is prevalent throughout America; it is the number one cause of death for Americans. Common heart conditions include high blood pressure, coronary artery disease, heart failure, congenital heart disease and pulmonary hypertension; these conditions, even when well managed, can elevate your risk of becoming seriously ill if you contract COVID-19. In this segment of the Guide to Good Health’s Ask the Expert series, we spoke with Alan Bramowitz, MD, of Jefferson Cardiology about the impact of the virus on people with heart disease.

Q: Cardiovascular disease is always listed as an underlying condition that puts people at higher risk of severe illness if they contract COVID-19. Why is this?
A: All published reports indicate a high prevalence of persons at risk for cardiovascular disease as well as known heart disease among hospitalized patients with COVID-19. High blood pressure, obesity and diabetes in that order appear to be the most common existing conditions followed by history of heart disease. Cardiac complications can result from several causes. In persons with severe pneumonia and resulting respiratory failure there can be stress placed on the heart without heart muscle damage resulting in threatening heart rhythm disorders and shock. Also, the virus can cause direct heart muscle damage. The enzyme in lung tissue lining that is attacked by the virus to gain entrance to lung tissue is also present in the heart, kidneys, arteries and intestine. This is the suspected mechanism causing direct heart damage. Heart damage can be rapidly detected by checking a blood test measuring heart muscle damage.

Q: How does COVID 19 affect the heart?
A: COVID 19 can cause abnormal heart rhythms which can make the heart beat erratically and ineffectively; they can also be lethal. The inflammation from COVID 19 and the body’s often overwhelming immune response to the virus can cause myocarditis and pericarditis, inflammatory conditions that can damage the heart muscle. The inflammation caused by COVID 19 can weaken the heart. COVID 19 causes abnormalities in the blood clotting system and this can lead to emboli, blood clots that travel to the heart and lungs. Weakened heart performance may contribute to kidney failure requiring dialysis.

Q: Are people with heart disease more likely to die if they get COVID-19?
A: There is a higher incidence of death in patients with heart disease who develop COVID 19. This has been reported in China and in Italy and we are seeing similar results in the U.S. People with cardiovascular disease and high blood pressure have worse outcomes but we are not sure exactly why. It may be that these diseases occur primarily in the older population and older adults have weaker immune systems. We know that people who have heart damage from COVID have a higher risk of dying.

Q: Does COVID 19 leave permanent damage to the heart?
A: It’s possible but it’s too early to know if damage to the heart muscle is permanent. It’s still so new and we are learning as we go, but it probably depends on how severe your disease was. Some patients have serious damage to the heart muscle, while others have none.

Q: What actions should I take to keep my heart as healthy as possible during this pandemic?
A:

  • Eat healthy food, sleep well, keep well hydrated, manage stress as much as possible and practice social distancing.
  • This is a stressful experience for all of us. If you need help or support, ask for it. The fear and isolation can be very difficult.
  • Keep taking your heart medications exactly as your doctor ordered. In the beginning there was concern that statins could help the virus enter the lungs, but we now know this is not true. Both the American Heart Association and the
  • American College of Cardiology recommend that you continue to take your meds.
  • Make sure you have an adequate supply of your medications.
  • Think about having a telemedicine appointment with your doctor so that you can limit your exposure to the virus and help slow the spread.
  • If you experience symptoms that could be early signs of COVID 19, call your PCP’s office and they will guide you.

Q: The main message?
A: Heart disease is very common in the U.S. Having heart disease does not make you more likely to get COVID 19 but if you do get it, you will not do as well as people with healthy hearts. Heart disease does put you at increased risk of having a more severe illness.

To learn more about heart disease, visit www.jeffersoncardiology.com


For more information, visit www.aetnamedicare.com and https://aetna.benefitscheckup.org/welcome-aetna/             

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