Why COVID-19 Could Raise Your Heart Attack Risk

She was in what looked like a hazmat suit, her face covered with two masks, and her eyes covered with goggles as she entered the room in the intensive care unit. Six feet away in the bed was a colleague, an ophthalmologist in his 40s, and he was talking at a rapid-fire pace.

This was March 2020, in the early days of the COVID-19 pandemic, and he wanted to know how it was that the virus had led to a heart attack, landing him in the ICU. He asked if she was seeing more people like him—somewhat younger than the typical cardiac patient, with no risk factors, seemingly healthy before getting sick—and he was frightened.

“Do you all know what in the world you’re doing?” the man asked.

She wasn’t entirely sure how to answer that question. Although Evelina Grayver, MD, FACC, director of the Women’s Heart Program at the Katz Institute for Women’s Health and an assistant professor in cardiology, was one of the first on the front lines, the virus was still new at the time. Even newer was the idea that COVID-19 could inflame the heart to such a degree—and do so in patients who otherwise would not have developed heart conditions.

“In addition to trying to express to me his wishes and who he wanted to make decisions for him, he wanted to understand whether there was any hope for him,” Grayver recalls.

The patient survived the heart attack but was on a ventilator for so long his lungs took a hit, and he ended up undergoing a tracheostomy and receiving a feeding tube. Eventually, he was moved to a nursing home. Now, she says, he is at home with his family, although she’s unsure in what condition.

Since COVID-19 began, heart attacks have risen across virtually all age groups. What’s striking is that patients aged 25 to 44, who are less likely to suffer a cardiac incident than older age groups, saw the rate of heart attacks increase 30% over the first two years after the pandemic.

How COVID-19 impacts the heart

According to the National Institutes of Health (NIH), the virus causes lung damage, which can block oxygen from reaching the heart muscle, which then leads to damage of the heart tissue and prevents it from getting oxygen to other tissues.

In addition, when attacked by a virus, the body naturally and appropriately responds with inflammation. But with COVID-19, “the inflammation seems to go into overdrive,” the NIH stated. “Too much inflammation may further damage the heart or disrupt the electrical signals that help it beat properly.”

The virus has also been known to create small blood clots throughout the body and in the heart, which can damage it.

“It’s difficult to say whether this all correlates directly to COVID-19, versus other dilemmas after COVID-19, like people becoming more sedentary or not keeping up with medical exams and addressing their chronic issues,” Grayver explains. “But we do know that the virus has caused an inflammatory response in the body, and any sort of inflammation can cause an increase in cardiovascular disease. Some recover, and some don’t.”

Although some patients would have eventually developed cardiovascular disease later in life, “it’s most likely that the virus itself can trigger an inflammatory cascade in those patients who might never have had heart disease,” she says.

Grayver tells patients, family, and friends to be vigilant, pleading with them to pay attention to their symptoms post-COVID-19 and take them seriously.

“This may not present as an elephant on the chest,” she says. “You may have symptoms like shortness of breath, cough, and fatigue. You may be in good shape otherwise. But anything outside the norm must be evaluated.”

If, for example, you are at the gym and are far too fatigued and out of breath, with chest tightness, to finish an exercise you normally would, you should go see a physician.

Grayver still thinks about the ophthalmologist and the other patients she encountered in the ICU during the pandemic.

“The most important thing I took away from that,” she says, “is that time is something none of us should ever take for granted.”

• COVID-19 Vaccine Myths Debunked
• Improving Heart Health Post-COVID
• The Connection Between COVID And Diabetes