Spanish
In some ways, the relationship between viruses, vaccines, and heart health is simple.
“Think of your heart as your home,” says Dr. Jorge Alvarez, an interventional cardiac specialist at Methodist Heart Clinic in San Antonio. “A house has walls, which are like walls of the mind. There are doors, which are valves. And then there are plumbing and electricity.
“The virus can affect every aspect of your home,” he says.
That’s why vaccination against COVID-19, influenza, and other illnesses is an important way for people with heart disease to protect themselves.
That fact could get lost in the swirl of new information, not to mention misinformation surrounding vaccines. Now that the latest COVID-19 vaccines are available and can be given at the same time as the flu shot, here’s what people with cardiovascular disease need to know about the virus and vaccines. , here are more honest answers from experts.
Virus poses serious heart risks
Heart problems and infections are linked in many ways. One of them is inflammation, said Dr. Saate Shakil, assistant professor of cardiology at the University of California, San Francisco.
Illnesses caused by viruses such as coronavirus, influenza, and respiratory syncytial virus can cause inflammation. The same goes for bacterial diseases such as pneumonia.
If you have coronary heart disease, plaque-filled arteries restrict blood flow. In such cases, inflammation can cause plaques to rupture, blood clots, and artery blockages, which can lead to heart attacks and strokes, according to a study looking at the link between COVID-19 and stroke. Mr. Shakil said.
Other studies have shown that:
– Problems such as heart attacks and heart failure (when the heart can’t pump properly) occur in about 20% of adults hospitalized with RSV, according to a 2018 study published in the Journal of the American College of Cardiology. To do.
– COVID-19 is associated with increased risk of arrhythmia, heart failure, and coronary artery disease. A 2021 study published in The Lancet found that COVID-19 was associated with a three- to eight-fold increased risk of heart attack and a three- to seven-fold increased risk of stroke.
– The risk of a heart attack can increase up to six times in the first week after being diagnosed with the flu, according to a 2018 study published in the New England Journal of Medicine.
The virus doesn’t have to attack the heart directly to put it at risk, Shakil said. People with pneumonia have difficulty breathing, which can put strain on the heart.
Meanwhile, Alvarez said high fevers caused by infections can cause heart rhythm problems in certain people.
Vaccines protect against those risks
Alvarez compares cardiovascular problems to a campfire. In his analogy, cholesterol, which causes arterial plaque, is like a growing pile of wood. Inflammation is mild fluid. All are triggered by a viral or bacterial infection.
Vaccines, he said, are like a bucket of water for the game, stopping the entire process.
A research letter published in February in JACC found that vaccination was associated with a lower risk of heart attack, stroke, and other cardiovascular events among more than 1.9 million people infected with the coronavirus.
Meanwhile, influenza vaccination is associated with a lower risk of stroke. An analysis published in the Journal of the American Heart Association in 2021 found that influenza vaccination was also associated with an 18% lower chance of dying from cardiovascular disease and a 25% lower chance of dying from any cause. It was related.
The Centers for Disease Control and Prevention says people with heart disease or stroke should talk to their health care team about getting vaccinated against COVID-19, influenza, and pneumococcal infections, including pneumonia and meningitis. There is. You should also keep up with the Tdap vaccine, which protects against diphtheria, tetanus, and whooping cough (also known as whooping cough).
The CDC also recommends that adults 60 and older ask about the new RSV vaccine.
Your health care professional can give you advice about other vaccines and whether certain formulations should be avoided. For example, the CDC says people who are pregnant, immunocompromised, or over 50 should not receive the nasal spray flu vaccine, which is a live virus-based vaccine. . “It’s not that we can’t get vaccinated,” Shakil said. “We just need to tailor the type of vaccine to them.”
The risks of vaccination are real, but the benefits far outweigh them.
Vaccines can have side effects. For example, the COVID-19 vaccine has been linked to rare cases of myocarditis or pericarditis, a type of heart inflammation.
Dr. Gregory Piazza, chief of vascular medicine at Brigham and Women’s Hospital in Boston, said this needs to be seen in context.
“It’s a very rare event that we’re talking about the risks of vaccines,” said Piazza, who is also an associate professor at Harvard Medical School. “And you’re putting that in conflict with the tremendous benefits that could be gained by reducing the severity of COVID-19 infection and reducing the likelihood of hospitalization and cardiovascular complications.”
“These are real, tangible benefits,” he said.
Piazza, who designed and oversaw a large national study of COVID-19 patients, said the range of serious side effects is “very small. Very small.” For example, some people who received the vaccine had problems with blood clots.
“But when people are hospitalized with COVID-19, many people have blood clot issues,” Piazza said. A British study published in Circulation in 2022 found that among 1.4 million COVID-19 patients, 10,500 cases of blood clots were more dangerous than would be expected in the absence of COVID-19. It turns out that this happens a lot.
When Mr. Alvarez’s patients expressed concerns about the risks of the vaccine, Mr. Alvarez said that the risk of getting into a serious car accident on the way to his office (a risk that all of his patients accepted) was outweighed by the serious risks of the vaccine. He pointed out that the risk of severe reactions was higher.
“Vaccines are safe, effective and will help save lives,” he said.
Shakil said patients often ask questions about vaccine safety, so they looked at each patient’s medical history to determine the risks. “I see a lot of patients, and I don’t think there was a single patient who looked at the data and felt that vaccination was a risk. If anything, vaccination would have been a greater risk.” They had contracted the coronavirus but had not been vaccinated. ”
Vaccines aren’t perfect
Despite their overall benefits, COVID-19 and influenza vaccines do not stop all infections. That doesn’t mean they didn’t work, Alvarez said.
He likens vaccines to helping test your immune system. You may not get a 100% score, but you will do much better than someone who didn’t study at all.
You don’t have to solve this alone
Worried or confused about which vaccine you need? It’s okay to blame your cardiologist or primary care doctor, Alvarez says.
Ask them to explain their reasoning, then openly accept what they have to say. “These things require some thought and discussion,” he said.
There are no stupid questions, says Shakil. “The worst thing that can happen is you walk away with more information than you came in with.”
To find locations offering COVID-19 and influenza vaccines, visit the federal website vaccination.gov or call 800-232-0233.
