Concern Grows Over COVID-19's Impact on Heart Muscle

Medical researchers continue to connect COVID-19 infections to lingering inflammation of the heart muscle, which can lead to serious cardiac issues.

But morestudies are needed to clarify the impact of the coronavirus before morepatients suffer this type of inflammation, known as myocarditis, which canresult in heart failure or even sudden cardiac death, says Sandra Chaparro, M.D., cardiologist and director of the AdvancedHeart Failure program at Miami Cardiac & Vascular Institute.

The lateststudy comes from Germany and is published in the journal JAMA Cardiology. It involved 100 adults, ages 45 to53, who had recently recovered from COVID-19 in Germany. About one-third ofparticipants required hospitalization, while the rest were able to recover athome. MRI scans were taken more than two months after testing positive. Aboutthree-quarters of these patients showed signs of heart abnormalities, includinginflammation of the heart muscle, or myocarditis.

“Thisis a very important study. It showed the damage that the virus does to theheart with a great imaging tool that we commonly use to evaluatecardiomyopathies, the cardiac MRI,” said Dr. Chaparro.

Cardiomyopathyis a disease of the heart muscle, which can lead to heart failure – when theheart is too weak to pump blood throughout the body.

Manypatients in the German study also were diagnosed with some levels of troponin,a protein in their blood. Troponins are proteins in the cardiac and skeletalmuscles. When the heart is damaged, it releases troponin into the bloodstream.Doctors measure your troponin levels to detect whether a patient is suffering aheart attack.

In April,preliminary studies from the U.S., China and Italy by cardiac experts foundthat COVID-19 can infect the heart muscle, leading to heart failure and death,even among those who showed no signs of respiratory distress. “The myocardiumin the heart has some of the receptors that the virus can use to enter intocells and cause some damage,” said Dr. Chaparro.

The German researchers in the latest study said they are not certain what their findings mean for patients’ heart health in the long term after recovering from COVID-19. The heart issues observed in the study occasionally occur with respiratory diseases, such as influenza, and could be temporary. Mild cases of heart inflammation may not show symptoms and often improve on their own, says the National Heart, Lung and Blood Institute.

The latest published research “demonstrates that our understanding of the virus is evolving and we need to continue with more research to evaluate the long-term consequences of COVID 19 infection, ” said Dr. Chaparro.