As COVID-19 continues to impact people of all ages, researchers and physicians are working tirelessly to learn everything they can about the virus. COVID-19 brings so many questions for all of us, but for patients with heart disease, those questions often come with greater worry as they are already managing health problems and risk factors. February is American Heart Month, so we asked WakeMed cardiologists to address a few common concerns about COVID-19 and heart health.
How is COVID-19 impacting people with heart problems? Early evidence has shown that people with cardiovascular conditions, as well as those with risk factors such as heart disease, cardiac arrhythmia, high blood pressure, elevated cholesterol, or diabetes, are at higher risk of complications related to COVID-19. “Patients without heart conditions may develop them due to the virus,” adds WakeMed cardiologist Dr. Jason Haag. That’s why it’s very important for everyone to watch for cardiac symptoms. “Keep an eye out for chest pain, shortness of breath, increased swelling, weight gain, dizziness, or palpitations.”
Is it safe to see my cardiologist right now? Regardless of what’s going on around us, we know that heart disease and other cardiac problems are chronic conditions that need to be monitored carefully. Getting the care you need means you will get better faster and limit long-term damage to your heart, lungs, and overall health.
“We understand our patients are at greater risk of complications, so whether you prefer a virtual or an in-person visit, we’ve done everything we can to make your appointment as safe and efficient as possible,” says Dr. John Sinden, cardiologist with WakeMed Heart & Vascular. From symptom screening and temperature checks for patients and staff to wearing masks, offering electronic check-in, the ability to wait in your car rather than the lobby, modifying layouts, and, as always, deeply disinfecting all surfaces throughout the day – the health and safety of patients and staff is top priority for medical professionals.
I have heart failure – what do I need to know about COVID-19? “Continue to take your medications as prescribed, watch your diet and sodium intake, and maintain your routine care,” shares Dr. Stuart Russell with WakeMed Heart & Vascular – Advanced Heart Failure. While there hasn’t been much data published about COVID-19 patients with existing heart failure, there have been numerous reports of people developing heart failure as a result of COVID-19. “What we do know is that keeping a close watch on your condition is always in your best interest,” Dr. Russell adds. In addition to offering virtual and in-person visits, new technologies including implantable cardiac defibrillators and cardiac fluid sensors to track how well your heart failure is being managed are available.
I have an arrhythmia – what do I need to know about COVID-19? “We do know that any infection can trigger and worsen atrial fibrillation in patients,” says Dr. Ashish Patel, a WakeMed cardiologist who specializes in electrophysiology. The good news for current arrhythmia patients, Dr. Patel shares, is that there are many options that allow physicians to monitor cardiology patients from the comfort and safety of home. These include implanted devices such as pacemakers, defibrillators, and looper recorders that can provide continuous monitoring. Non-implantable devices such as the KardiaMobile device or an Apple Watch can also track your rhythm, and data can be electronically sent directly to your cardiologist.
What long-term effects on the heart are we seeing in patients who have recovered from COVID-19? “It’s important to note that this virus is still in its earliest stages, so ‘long-term’ for us at this point is fairly limited,” explains WakeMed cardiologist Dr. Senthil Sundaram. With that said, doctors are seeing increased incidence of both myocarditis (inflammation of the heart muscle) and thromboembolic complications such as deep vein thrombosis (DVT) in patients who have recovered from COVID-19.
These findings are not limited to patients who had severe COVID-19 or to those with previous history of cardiac disease. “While preliminary studies have brought light to these potential complications, the data is still very early and we likely need another six - 12 months of data before we can make sound conclusions,” Dr. Sundaram adds. “What we do know is that anyone who has had COVID-19 and experiences lingering symptoms should be closely followed by their primary care physician, or a cardiologist, if needed. In the coming year, we should know a lot more about what the long-term effects may be.”
How can I stay healthy, active, and connected at home? Remaining active in this “new normal” is more important than ever since exercise can have a positive effect on the cells and molecules of the immune system. It is paramount that we find creative ways to exercise regularly – even while social distancing. You can get active at home with your family, or virtually through exercise videos and apps. Take this opportunity to get more comfortable with new technologies – or stay active through walking, yardwork, or at-home exercises. As it relates to diet, make sure you’re getting a well-balanced diet of fresh fruit, vegetables, and limit processed foods that are likely to be high in sodium, sugar, and fat. Set activity goals and challenge yourself to meet them.
WakeMed cardiologist Dr. Hemant Solomon explains, “Cardiac patients need emotional and physical support due to their underlying chronic illness.” To achieve this while keeping higher-risk family members safe, Dr. Solomon recommends keeping visits short, limiting gatherings to less than 10 people, and wearing a mask. He also urges patients to get their flu vaccine, which can at least reduce your risk for one of the season’s common illnesses.
The bottom line is cardiovascular events don’t stop during a pandemic. Don’t ignore symptoms and don’t delay care. “That’s why we’re here for our patients, 24/7,” said Dr. John Sinden. When it comes to these symptoms, calling 9-1-1 offers the best chance of surviving or saving a life. “Just like we’ve done throughout the hospital and physician offices, emergency departments have put many precautions in place to ensure patients get the care they need in the safest environment possible.”
For more information about cardiovascular care and services at WakeMed, visit wakemed.org/hearts.