Image: Kari Perrin

Those who have recovered from Covid-19 may have lingering heart conditions that are affecting their daily lives. While heart complications, such as an irregular heartbeat, palpitations and chest pain, are common short-term symptoms, there are long-term conditions that can be contracted as part of "long Covid" that should be monitored and treated by a cardiologist.

Sarasota cardiologist Dr. Chippy Ajithan explains some of the short- and long-term effects, and what treatments and lifestyle changes can be made to best help heal from these conditions.

What are the short-term effects of Covid-19 on the heart?

Ajithan says that symptoms patients may experience are shortness of breath, chest pain, arrhythmias (irregular heartbeat, either too fast or too slow) and palpitations.

"These symptoms can come from both the top and bottom chambers of the heart," says Ajithan.

For some patients, these symptoms will go away once completely recovered from Covid-19. But for others, heart conditions may linger, as a part of what clinicians are calling "long Covid."

What are the long-term effects of Covid-19 on the heart?

"Evidence of injury on the cardiac troponin—proteins found within the heart muscle—are seen in a significant portion of hospitalized patients based on current studies," says Ajithan. She cites a recent study from the European Society of Cardiology that shows nearly one in three patients hospitalized with Covid demonstrate a myocardial, or heart muscle, injury.

Myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the heart's covering) can be long-term effects of Covid-19. Ajithan also says Covid can increase the risk of plaque instability in the blood vessels, causing blood clots.

"Autopsy studies have shown that there are micro-clots as part of the reason for that heart muscle damage," says Ajithan. These clots can result in heart attacks and strokes.

Ajithan says a condition called dysautonomia can also be found in long Covid patients. This condition is a dysfunction of the nerves that regulate things like heart rate and blood pressure. Postural orthostatic tachycardia syndrome may develop or worsen in patients already dealing with the condition, which causes a drop in blood pressure when you stand up.

According to an article by Hopkins Medicine, the worse your case of Covid-19, the more likely you are going to have long-term impact to your heart.

How long do long-term effects tend to last?

"Acute injury to the heart seems to plateau after six months, but longer term studies are needed," says Ajithan. "Magnetic resonance imaging studies have shown evidence of inflammation of the heart muscle two to three months after a Covid diagnosis."

In another study Ajithan found, 60 to 80 percent of discharged Covid-19 patients from the hospital report some residual symptoms even 50 days after their diagnosis.

Every patient is different, however, and will experience a variety of lingering effects based on preexisting conditions, lifestyle choices, how severe their Covid case was and more. Further studies are needed to see the lasting effects Covid has on someone's heart.

What are some treatment options available for Covid-19 related heart conditions?

According to an article published by the public media outlet WHYY, "some long-haulers, or those with lingering effects of Covid, have reported their symptoms resolved after getting the Covid-19 vaccine." There is some evidence to suggest that Covid vaccination could help improve symptoms of those with long Covid.

"Treatment for these heart conditions is supportive care and use of guideline-directed medical therapy currently in practice for individuals with heart muscle damage, heart attack, arrhythmia and dysautonomia," says Ajithan.

Ajithan also says lifestyle practices are fundamental to improvement. With her own cardiac patients who have recovered from Covid, she continues to stress proper nutrition, with a focus on anti-inflammatory foods. She also recommends light movement and exercise, based on physician recommendations and management of stress.

For those struggling with long Covid symptoms and are in need of support, visit the Long Covid Alliance's website for resources.

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