ST. LOUIS (AP) – Firefighter and EMT Mike Camilleri once had no trouble carrying heavy equipment up a ladder. Now, in his long battle with the coronavirus, he is stepping cautiously onto the treadmill and learning how his heart responds to a simple walk.
“This is not a rigorous test, so don’t fake it,” cautioned Beth Hughes, a physical therapist at Washington University in St. Louis.
Somehow, a mild case of COVID-19 set off a chain reaction that ended up causing Camilleri to develop dangerously high blood pressure, rapid heart rate with even mild exercise, and severe chest pain.
He is never alone. The extent to which COVID-19 is taking a toll on the nation’s heart health is only beginning to become clear, several years after the pandemic began.
“Unfortunately, we have seen that the effects on the heart and vascular system actually outweigh the effects on other organ systems,” said Dr. Susan Chen, a cardiologist at Cedars-Sinai Medical Center in Los Angeles. “
This is not just a problem for long-term coronavirus patients like Camilleri. For up to a year after contracting COVID-19, people may be at increased risk of developing new heart-related problems, from blood clots to arrhythmias to heart attacks, even if they initially seem to be recovering well. There is a gender. .
Among the unknowns, who is most likely to experience these aftereffects? Are they reversible? Or is it a warning sign that your heart disease will get worse in the future?
Dr. Ziyad Al Ali, a clinical epidemiologist at Washington University in St. Louis, helped raise the alarm about lingering health problems after contracting COVID-19. (AP Video/Angie Wang)
“We are coming out of this pandemic as a sicker nation” due to virus-related heart disease, said Dr. Ziyad Al Ali of the University of Washington, who helped. sound the alarm About lingering health problems. The results “will probably have an impact for generations,” he added.
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Heart disease has long been the leading killer in the country and around the world. But in the United States, heart-related death rates had fallen to record lows in 2019, just before the pandemic hit.
COVID-19 has undone that decade of progress, Chen said.
Deaths from heart attacks rose with each surge of the virus. To make matters worse, young people shouldn’t have heart attacks, but Chen’s research demonstrated that heart attack deaths increased by nearly 30% in the first two years of the pandemic for 25- to 44-year-olds. .
An ominous sign that problems may persist: High blood pressure is one of the biggest risks for heart disease, and “people’s blood pressure has actually increased appreciably over the course of the pandemic,” she said.
Cardiovascular symptoms are called long coronavirus, an umbrella term for dozens of health problems, including fatigue and brain fog. The National Institutes of Health has begun several small studies. Possible treatments for certain long-term coronavirus symptomsincluding heartbeat issues.
Dr. Susan Chen, a cardiologist at Cedars-Sinai Medical Center in Los Angeles, explains the devastating toll COVID-19 has had on the nation’s heart health. (AP Audio/Angie Wang)
But Chen said patients and doctors alike need to know that cardiovascular disease can be the first or main symptom of the damage left behind by the coronavirus.
“These are people who don’t necessarily go to the doctor and say, ‘I’ve had COVID for a long time,'” she says.
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In St. Louis, after the coronavirus outbreak in late 2020, Camilleri first developed shortness of breath, then a series of heart-related and other symptoms. He tried various treatments from multiple doctors to no avail, and ended up at the University of Washington’s long-term coronavirus clinic.
Camilleri, 43, said: “We’ve finally steered in the right direction.”
There, he saw Dr. Amanda Verma as his blood pressure and heart rate problems worsened. Verma was part of a heart disease team that studied a small number of patients like Camilleri with complex heart conditions and found that blood flow abnormalities may be part of the problem.
Firefighter and EMT Mike Camilleri once had no trouble carrying heavy equipment up a ladder. Now, in his long battle with the coronavirus, he is stepping cautiously onto the treadmill and learning how his heart responds to a simple walk. (AP Video/Angie Wang)
how? When a person moves around, blood flow increases rapidly, and when a person is at rest, blood flow calms down. However, some long-term coronavirus patients may not get enough relief during rest because their fight-or-flight system, which controls stress responses, remains activated, Verma said. .
Some people also have problems with the inner walls of small blood vessels not being able to expand and contract properly to move blood, she added.
Hoping that would help explain some of Camilleri’s symptoms, Verma prescribed heart medications that dilate blood vessels and weaken the fight-or-flight response.
Back at the gym, Hughes, a physical therapist who treats long-term coronavirus patients, developed a careful rehabilitation plan after a treadmill test revealed an abnormally high heart rate for Camilleri. Ta.
“If I hadn’t taken Dr. Verma’s medication, things would have been much worse,” Hughes said, showing Camilleri exercises to do while lying down and monitoring his heart rate. To normalize that fight-or-flight response, “we need to rewire our systems.”
Camilleri said Verma mixed a prescription based on his reactions and noticed some improvement. However, he suffered further health problems after contracting the coronavirus for the second time in the spring, leaving him on disability and forced to retire.
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What are your heart risks after contracting coronavirus? To find out, Al-Aly analyzed medical records from the Department of Veterans Affairs’ extensive database. People who survived the early stages of the coronavirus pandemic were more likely to experience abnormal heartbeats, blood clots, chest pain, palpitations, and even heart attacks and strokes up to a year later than those who were not infected.This includes middle-aged people with no signs of heart disease
Based on these findings, Al-Aly estimates that 4 in 100 people will need treatment for some heart-related condition in the year after recovering from COVID-19. I estimated it.
Per person, it’s a small risk. But he said the sheer scale of the pandemic meant millions of people remained with at least some cardiovascular symptoms. Reinfection can still pose a problem, but Al-Aly is currently studying whether the overall risk has decreased thanks to vaccination and milder coronavirus strains.
Recent research confirms the need to better understand and address these cardiac aftershocks. An analysis this spring of a large U.S. insurance database found that patients with long-term COVID-19 infections were more likely to experience blood clots, abnormal heartbeats, and strokes in the year after infection than similar patients who had avoided COVID-19 infections. were found to be almost twice as likely to receive treatment for cardiovascular disease. .
Verma points out that the association with post-infectious heart damage is not all that surprising. She pointed to rheumatic fever, an inflammatory response to untreated strep throat that left scarring on heart valves, especially before antibiotics were common.
“Is this the next rheumatic heart disease? We don’t know,” she said.
But Al-Aly says there is a simple lesson. This means that if you ignore other heart risks, such as high cholesterol, blood pressure, uncontrolled diabetes and smoking, you won’t be able to change your COVID-19 history. It’s time to change that.
“These are things we can do something about. And I think they’re more important now than they were in 2019,” he said.
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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Education Media Group. AP is solely responsible for all content.
