COVID-19 is the disease which is caused by the new virus which is circulating through our community. It primarily affects the lungs and the heart through direct infection. The immune system responds to that infection with a sometimes robust response that can lead to symptoms of severe shortness of breath and even require respiratory support.
Most patients can recover, but patients who are either immunocompromised or elderly are at higher risk. Most people don’t have cardiac involvement at that point, but later in the disease, if it becomes more severe, then the heart function can decrease. The heart function sometimes decreases because of the systemic inflammatory response to the virus and in some people, because of direct viral infection in the heart develops myocarditis.
What is Myocarditis?
According to the Centers for Disease Control, “Myocarditis is inflammation of the heart muscle, and pericarditis is inflammation of the outer lining of the heart. In both cases, the body’s immune system causes inflammation in response to an infection or some other trigger”.
Myocarditis occurs in people mainly who have already been diagnosed with hypertension, coronary artery disease, and people who have decreased reserve capacity.
It may be that the medicines that are used to support blood pressure are actually leading to some deterioration and heart function. There is a difference between people with structural heart disease and the young person who comes in with an acute chest pain and shortness of breath.
In the older group, myocarditis is probably the result of having underlying heart disease. In the younger group, it is primary myocarditis.
People with COVID are also presenting with congestive heart failure. Doctors are not sure if the heart failure is related to myocarditis or the systemic inflammation that we see in COVID patients. Most people diagnosed with myocarditis are completely cured.
If people develop chest pain or shortness of breath, they should seek medical attention by calling their healthcare provider or if its severe, call 911.