More than just a lung issue? Doctors puzzled by cases where coronavirus damages heart
Doctors are finding that coronavirus could have some serious effects on more than just the lungs
COVID-19 is a respiratory illness that causes symptoms such as cough and shortness of breath. In some cases those infected experience trouble breathing and in severe cases need to be put on respirators and in intensive care. There’s also been some evidence that the virus can lead to long-term or severe lung damage.
But experts are finding that COVID-19’s threat extends beyond the lungs.
Doctors are seeing cases in which coronavirus affects the heart muscle, leading to heart damage, heart failure, and even cardiac arrest or death, Kaiser Health News reports.
A study published in JAMA Cardiology examined 416 coronavirus patients in China and found that about 19 percent of them experienced “cardiac injury” while hospitalized. These patients had a higher mortality rate.
Experts have long said people with underlying heart issues are at a higher risk when it comes to coronavirus.
But another study done by researchers at the University of Texas found COVID-19 can cause cardiac injury even in patients without underlying heart problems.
“It is likely that even in the absence of previous heart disease, the heart muscle can be affected by coronavirus disease,” Mohammad Madjid, the study’s lead author and an assistant professor of cardiology at McGovern Medical School at UTHealth, said in a release about the study. “Overall, injury to heart muscle can happen in any patient with or without heart disease, but the risk is higher in those who already have heart disease.”
Another report from doctors in Italy described a case in which a healthy 53-year-old woman was experiencing severe fatigue and told doctors she previously had a cough and fever. Her chest X-rays came back normal, but doctors found inflammation in her heart. Because of the COVID-19 outbreak, the patient was swabbed for the virus and her test came back positive.
The New York Times reported on a similar case in the U.S in which a 64-year-old patient came to the hospital with signs of a serious heart attack. But after finding no arteries were blocked, doctors determined the cause of the symptoms was coronavirus.
Cases like these have left doctors with the question of whether to “first rule out” coronavirus if a patient believes they are having a heart attack or if that would set them back too far in helping patients who are having a heart attack, The New York Times reports.
“I don’t know what the right answer is,” Dr. Nir Uriel, a cardiologist at Columbia University and Weill Cornell Medicine, told the Times.
It’s been known that any serious medical event or problem can affect the heart, KHN reports.
Research on past epidemics has shown that viral infections can cause heart problems and exacerbate or lead to heart failure, according to the University of Texas release.
But important questions remain about coronavirus specifically.
“It’s extremely important to answer the question: Is their heart being affected by the virus and can we do something about it?” Dr. Ulrich Jorde, the head of heart failure, cardiac transplantation and mechanical circulatory support for the Montefiore Health System, told KHN. “This may save many lives in the end.”
Much remains unknown about the virus, including why infection may lead to heart damage.
“Myocarditis can likely be caused either by the virus itself, or the body’s immune and inflammatory response to the virus,” Dr. Scott Solomon, a cardiologist at Harvard Medical School, told The New York Times.
Doctors told the Times it’s also possible that heart problems could be a consequence of lung infection.
“The lungs are not working, so there is not enough oxygen,” Dr. Peter Libby, a cardiologist at Harvard Medical School, told The New York Times. “That increases the risk for arrhythmias.”
But it’s also possible the virus infects the heart directly.
“We have to assume, maybe, that the virus affects the heart directly,” Jorde told KHN. “But it’s essential to find out.”
This story was originally published April 8, 2020 at 1:59 PM with the headline "More than just a lung issue? Doctors puzzled by cases where coronavirus damages heart."
