Nav: Home

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications

May 15, 2020

COVID-19 can cause serious cardiovascular complications including heart failure, heart attacks and blood clots that can lead to strokes, emergency medicine doctors report in a new scientific paper. They also caution that COVID-19 treatments can interact with medicines used to manage patients' existing cardiovascular conditions.

The new paper from UVA Health's William Brady, MD, and colleagues aims to serve as a guide for emergency-medicine doctors treating patients who may have or are known to have COVID-19. The authors note that much attention has been paid to the pulmonary (breathing) complications of COVID-19, but less has been said about the cardiovascular complications that can lead to death or lasting impairment.

"In writing this article, we hope to increase emergency physicians' knowledge and awareness of this new pathogen and its impact on the cardiovascular system," said Brady, of UVA's Department of Emergency Medicine. "As we encounter more and more patients with COVID-19-related illness, we are increasing our understanding of its impact on the body in general and the cardiovascular system in particular. The rate of learning on this area is amazingly rapid. Information continues to change weekly, if not daily."

COVID-19 and Heart Failure

Heart failure is a particular concern in patients with COVID-19. One study, the article authors note, found that almost a quarter of COVID-19 patients - 24% - were suffering acute heart failure when they were first diagnosed with the coronavirus. (This doesn't mean that 24% of all COVID-19 patients will suffer heart failure. The authors state that it remains unclear if the heart failure was the result of COVID-19 specifically or if the virus was worsening undiagnosed heart failure.)

Of the patients with heart failure, nearly half were not known to have high blood pressure or cardiovascular disease.

Strokes and Other Concerns

The paper also notes that COVID-19, and other diseases that cause severe inflammation throughout the body, increase the risk that fatty plaque built up in the blood vessels will rupture, leading to heart attacks and stroke. Influenza and certain other viruses have been associated with increased risk of plaque ruptures within the first week after the disease was diagnosed, the authors state in their review of the available COVID-19 medical literature.

Finally, the authors describe potential drug interactions in COVID-19 patients. For example, the highly publicized malaria drug hydroxychloroquine can interact with medications designed to regulate heart rhythm, in addition to causing heart damage and worsening cardiomyopathy. Remdesivir, an antiviral that is the only COVID-19 treatment authorized by the FDA, can cause low blood pressure and abnormal heart rhythm. It's important for doctors to bear these interactions in mind when treating patients with COVID-19, the authors note.

"As we gain more experience with this new pathogen, we realize that its adverse impact extends beyond the respiratory system," Brady said. "We will continue to learn more about COVID-19 and the most optimal means of managing its many presentations."

Findings Published

The article has been published online by the American Journal of Emergency Medicine. In addition to Brady, it was written by Brit Long, MD, of Brooke Army Medical Center; Alex Koyfman, MD, of the University of Texas Southwestern Medical Center; and Michael Gottlieb, MD, of Rush University Medical Center.
-end-
To keep up with the latest medical research news from UVA, subscribe to the Making of Medicine blog at http://makingofmedicine.virginia.edu.

University of Virginia Health System

Related Heart Failure Articles:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication
Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.
Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.
Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population
Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.
Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.
Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.
Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.
How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.
Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.
More Heart Failure News and Heart Failure Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Listen Again: The Power Of Spaces
How do spaces shape the human experience? In what ways do our rooms, homes, and buildings give us meaning and purpose? This hour, TED speakers explore the power of the spaces we make and inhabit. Guests include architect Michael Murphy, musician David Byrne, artist Es Devlin, and architect Siamak Hariri.
Now Playing: Science for the People

#576 Science Communication in Creative Places
When you think of science communication, you might think of TED talks or museum talks or video talks, or... people giving lectures. It's a lot of people talking. But there's more to sci comm than that. This week host Bethany Brookshire talks to three people who have looked at science communication in places you might not expect it. We'll speak with Mauna Dasari, a graduate student at Notre Dame, about making mammals into a March Madness match. We'll talk with Sarah Garner, director of the Pathologists Assistant Program at Tulane University School of Medicine, who takes pathology instruction out of...
Now Playing: Radiolab

What If?
There's plenty of speculation about what Donald Trump might do in the wake of the election. Would he dispute the results if he loses? Would he simply refuse to leave office, or even try to use the military to maintain control? Last summer, Rosa Brooks got together a team of experts and political operatives from both sides of the aisle to ask a slightly different question. Rather than arguing about whether he'd do those things, they dug into what exactly would happen if he did. Part war game part choose your own adventure, Rosa's Transition Integrity Project doesn't give us any predictions, and it isn't a referendum on Trump. Instead, it's a deeply illuminating stress test on our laws, our institutions, and on the commitment to democracy written into the constitution. This episode was reported by Bethel Habte, with help from Tracie Hunte, and produced by Bethel Habte. Jeremy Bloom provided original music. Support Radiolab by becoming a member today at Radiolab.org/donate.     You can read The Transition Integrity Project's report here.