Should You Get Your Heart Checked If You Had COVID-19?

More research is showing a link between coronavirus infection and increases in heart complications. The Centers for Disease Control and Prevention (CDC) lists heart palpitations or a fast-beating heart as examples of long-term effects of COVID-19. While less commonly reported, COVID-19 can cause long-term inflammation of the heart muscle.

Verywell spoke with experts on how COVID causes heart problems and whether you should get your heart checked out if you’re suspecting symptoms of a COVID-19 infection.

Direct Effects on the Heart

COVID-19 isn’t just a respiratory issue. According to Nicole Weinberg, MD, a cardiologist at Providence Saint John’s Health Center, the infection causes a big systemic release in the body that can hit any organ system, including the heart.

In response to the virus, the body’s immune system increases inflammation levels to help fight infection and repair injuries. However, prolonged inflammation associated with long-term illness causes collateral damage by mistakenly harming the body’s own cells and tissues.

 “It’s the inflammatory response stimulated by COVID-19 in the body that’s causing heart problems and death,” Weinberg says.

Allan Stewart, MD, a cardiothoracic surgeon for Kendall Regional Medical Center and HCA Healthcare Miami-Dade Market, tells Verywell that the inflammation is causing people to have heart arrhythmias, which is contributing to cardiac injury and death in hospitalized patients. There’s also the formation of a blood clot called thrombus that’s uniquely associated with COVID-19.

“This thrombus formation enters the heart or coronary arteries, and that’s causing diffuse injury to the muscle,” Stewart says. “This can have a long-term effect of having many mini heart attacks happening during a course of infection in hospitalized patients with severe disease.”

Indirect Effects on the Heart

People have been afraid of going to the doctor or the hospital during the pandemic for fear of getting infected with COVID-19. This lack of care has led to increased at-home heart complications and death. Research presented at a recent medical conference in January found a 53% reduction in adult cardiac surgeries in 2020 compared to in 2019.

“It doesn’t mean heart disease has been cured. It means that we got rid of all elective procedures and didn’t do appropriate diagnostic testing, and people were afraid to come to the hospital, so they suffered at home,” Stewart says. “People with hypertension and coronary heart disease had a massive spike in home deaths; it’s unlikely they all just had COVID-19 and a heart attack at home. They needed to come for their routine care, diagnostic testing, and to get refills on prescriptions, but they didn’t come. Fear of getting COVID-19 lead to a huge spike in home deaths.”

Who’s Most at Risk?

When it comes to heart complications from COVID-19, the American Heart Association reports older patients with a history of coronary heart disease or high blood pressure are at increased risk. But experts add anyone is vulnerable.

“People with a history of heart disease are much more likely to have cardiovascular complications with COVID-19,” Weinberg says. “But you can have no cardiovascular disease, potentially be young and healthy, and still end up with a cardiomyopathy after COVID-19 infection.”

Here’s the scientific evidence:

• A small July 2020 study in JAMA Cardiology found 60% of COVID-19 patients had myocardial inflammation, even if there was no history of preexisting conditions.
• An October 2020 study in JAMA Cardiology observed myocardial injury in athletes who had mild and asymptomatic COVID-19 cases.
• A small September 2020 study in JAMA Cardiology found that of 26 college athletes infected with COVID-19, four experienced myocarditis. Two of the four had pericardial effusion, and another two had myocardial inflammation.

Monitoring Your Heart Health

Weinberg recommends contacting a health professional if you’re experiencing the following symptoms during a COVID-19 infection:

• Shortness of breath
• Chest pain
• Heart palpitations
• Feeling lightheaded or faint
• Fatigue

Research on long-term cardiac effects after COVID-19 infection is still ongoing. While Stewart says it’s still too early to consider cardiac damage a symptom of a COVID long-hauler, he has seen people several months out from active infection with profoundly reduced heart function.

If a patient were experiencing the above symptoms, Weinberg says she would typically ask them to come in for a consultation. During the appointment, a cardiologist would perform three baseline assessments to measure heart health.

• EKG
• Echocardiogram
• Stress test

Additional tests may be ordered depending on the results of the three assessments.

To monitor your heart at home, Weinberg says that smartwatch technology has helped her patients keep track of abnormal heart rates, blood pressure changes, and drops in oxygen levels.

“With Apple Watch technology, you can do something similar to an EKG. And a lot of patients have those flow cytometry devices to monitor their oxygen status,” Weinberg says. “I love when I’m on call, and people give me lots of data. That’s the same type of stuff I would be asking in the emergency room if they were being screened there."

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.