What to Know About Cardiomyopathy and COVID-19

People with heart problems have a greater risk of becoming severely ill from developing the novel coronavirus disease (COVID-19). Furthermore, the virus has been found to significantly damage heart muscle, causing conditions like heart failure even after you've recovered from the viral infection. Cardiomyopathy—one of the major causes of heart failure—is both a major risk factor and serious complication of COVID-19.

Female doctor listen to senior patient heart

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Cardiomyopathy and COVID-19 Risk

Cardiomyopathy refers to diseases of the heart muscles. It causes them to become weak so the heart has difficulty pumping blood and becomes incapable of maintaining a normal electrical rhythm, resulting in heart failure and arrhythmia.

Data collected over the past year have revealed that people with high-risk conditions like cardiomyopathy are 10%–20% more likely to become severely ill with COVID-19 than people without high-risk conditions. The novel coronavirus is particularly attracted to angiotensin-converting enzyme 2 (ACE-2) receptors, which are found in abundance in healthy heart and lung tissues. When the virus attaches to these receptors, it can cause severe inflammation and permanently or fatally damage heart tissues.

One of the reasons that people with cardiomyopathy become severely ill with COVID-19 is that the disease causes a flood of inflammatory cells called cytokines to be released from the immune system into the blood. These cells can thicken blood, making it harder for the heart to move blood throughout the body and increasing a person's chance of developing a blood clot.

This is even more of a problem when your heart has already been weakened by diseases like cardiomyopathy before you develop COVID-19. If you become severely ill with COVID-19, cardiomyopathy and other cardiac complications of the disease can lead to cardiogenic shock and multiple-organ failure, increasing the risk of death.

Complications of Cardiomyopathy and COVID-19

In addition to being more susceptible to severe illness, people with heart problems like cardiomyopathy are also at risk of developing chronic complications even after the illness resolves. This is due to the body—especially the heart—becoming weaker by COVID-19.

Many tissues have the ability to rehabilitate themselves after illness, but heart tissue does not. Once heart tissue is damaged, your heart function is permanently lowered. The goal then becomes to prevent further tissue loss or damage as the heart works to compensate for its weakness and avoid complications from the loss of blood flow to other organs.

Studies performed in the months after people developed even mild cases of COVID-19 have found that the cardiac fallout from the virus may be long term or permanent for some. Long COVID symptoms like shortness of breath and chest pain are well documented, but experts suggest that long-haulers—those who experience long-lasting effects after an illness—may even be affected by more serious complications, such as chronic inflammation and new heart dysfunction.

These complications can lead to a new diagnosis of heart failure or cardiomyopathy in people who have had COVID-19 or can worsen existing heart conditions in those who already have them. Some researchers have even suggested that cardiomyopathy and heart failure may be the natural result of COVID-19 rather than a rare complication.

Cardiomyopathy Caused by COVID-19 Stress

Since the pandemic started, many people have experienced stress from quarantine, worries about getting sick, political tension, job loss, and more. Some evidence has suggested that this strain is leading to some cases of a rare form of cardiomyopathy called Takotsubo syndrome, or stress cardiomyopathy. Sometimes referred to as broken heart syndrome, this condition occurs after an extremely stressful physical or emotional event. It causes weakness on the left side of the heart, which pumps blood out to the body.

Before the pandemic, about 1%–2% of acute coronary syndrome cases were attributed to stress cardiomyopathy. During the pandemic, this number rose to about 8%. Some of these cases were traced to the havoc that the virus wreaks inside the body, but a large number developed in people who had tested negative for COVID-19.

Certain groups of people are at higher risk of experiencing stress cardiomyopathy, including postmenopausal women and people with existing mental health challenges.

Treatments for Cardiomyopathy and COVID-19

Treatment for cardiomyopathy primarily focuses on improving the heart's ability to pump blood to areas of the body that are damaged, preventing complications like fluid buildup and treating other adverse effects of poor heart function.

Some medications frequently prescribed for cardiomyopathy include:

Because these medications will not increase a person's risk of contracting COVID-19 or of experiencing severe symptoms if they do become sick, they are safe to take. Do not stop or change the dosage of your heart medications without consulting your healthcare provider first.

Implantable pacemakers or defibrillators also may be recommended to help the heart function better. However, these forms of treatment are invasive, and these devices, which can be monitored virtually through telehealth, can pose complications in people with cardiomyopathy and heart failure.

If you have a pacemaker or defibrillator, you most likely already take a medication that helps prevent blood clots from collecting around the device. Since the risk of blood clots increases during a coronavirus infection, be sure to continue taking the anticoagulant medications your healthcare provider has prescribed.

Some over-the-counter (OTC) medications—especially ones used to treat the symptoms of COVID-19—can be dangerous to people with certain heart conditions or who are taking other medications. Certain decongestants or cold medicines, for instance, can change your heart rhythm. Be sure to talk to your healthcare provider about what OTC medications you can take or should avoid if you have cardiomyopathy.

Frequently Asked Questions

Should I Get a COVID-19 Vaccine If I Have Cardiomyopathy?

Yes. It's not only safe to get one of the vaccines approved to prevent COVID-19, it's also highly recommended. People with cardiomyopathy are at high risk of developing severe illness due to COVID-19. The American Heart Association supports the COVID-19 vaccination for patients with a variety of heart conditions, including cardiomyopathy. While the vaccines are new and there is some risk of side effects or rare reactions, the immunity benefits are viewed as outweighing any vaccination risks.

Can COVID-19 Cause Cardiomyopathy?

Yes. COVID-19 has been found to cause heart damage and consequently a number of heart problems, including cardiomyopathy, even after people recover from COVID-19. Nearly one-fourth of those hospitalized with COVID-19 have been diagnosed with cardiovascular complications, which have contributed to roughly 40% of all COVID-19-related deaths.

Is COVID-19 More Dangerous for People with Cardiomyopathy?

Yes. The novel coronavirus affects heart and lung tissue and can cause permanent damage to these organs. As more information becomes available on the long-term consequences of COVID-19 infection, it's become clear that survivors may have lifelong cardiovascular hurdles to overcome.

In severe COVID-19 infections, sepsis and cardiogenic shock are common complications. There also has been evidence that some people who become severely ill with COVID-19 go on to develop Takotsubo syndrome, or stress cardiomyopathy. How this form of nonischemic cardiomyopathy develops in people with COVID-19 isn't quite clear, but there is a link to sepsis and increased death rates in hospitalized COVID-19 patients.

Should I See a Healthcare Provider If I Have Cardiomyopathy and COVID-19?

If you are having complications from cardiomyopathy that cause shortness of breath, chest pain, or heart palpitations, you should see your healthcare provider. Call 911 immediately if you are in immediate danger. If you are experiencing any kind of acute illness, do no hesitate to seek medical care.

How to Stay Safe

There are a number of measures you can take to reduce your chances of contracting COVID-19:

  • Social distancing
  • Wearing a mask
  • Practicing good hand hygiene
  • Becoming vaccinated when you can

Additionally, people with high-risk conditions like cardiomyopathy may want to take some extra precautions, such as to:

  • Stock up on at least 30 days of your regular medications
  • Consider setting up deliveries for food and medications
  • Make sure you have medical supplies like oxygen tanks and tubing if you need them
  • Make sure you are up-to-date on all vaccinations
  • Discuss a plan with your healthcare provider to safely continue with regular care for your condition
  • Consider using telehealth with your healthcare provider to reduce exposure
  • Consider rescheduling nonessential appointments or procedures
  • Stay healthy with a good diet and regular exercise

A Word From Verywell

Not only is cardiomyopathy a risk factor for a more severe case of COVID-19, it can also be a complication of the disease. Because of that, people with cardiomyopathy should take precautions to avoid contracting the novel coronavirus and talk to their healthcare provider about how to manage their condition if they do end up getting COVID-19. If you suffer from long-term COVID-19 complications, such as ongoing shortness of breath or chest pain, be sure to follow up with your healthcare provider.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Rachael Zimlich, BSN, RN
 Rachael is a freelance healthcare writer and critical care nurse based near Cleveland, Ohio.