32 LONGISLANDPRESS.COM • FEBRUARY 2022
PRESS HEALTH
COVID-19’S EFFECT ON HEART HEALTH
Some patients also experience pericarditis,
which refers to infl ammation of the
sac surrounding the heart. “It’s like having
a sunburn around the lining of your
heart – it causes a lot of pain,” said Dr.
Richard Shlofmitz, chairman of cardiology
at St. Francis Hospital, The Heart
Center in Roslyn, who noted that pericarditis
incidence was more common earlier
in the pandemic.
Blood clots are also associated with Covid
19 and have led to serious complications,
especially early in the pandemic,
according to Dr. Shlofmitz. Clots can
form in the legs, coronary arteries, lungs,
and elsewhere and can potentially lead
to heart attacks, strokes and other lifethreatening
emergencies.
But for most patients, the heart largely
acts as a “bystander” as the body responds
to the Covid-19 infection, according
to Dr. Ruwanthi Titano, a cardiologist
with the Mount Sinai Health System.
LONGHAUL SYNDROME
Mount Sinai founded the fi rst-of-its-kind
Center for Post-Covid Care in May 2020
to help patients suff ering from Covidrelated
symptoms long after their acute
infection has subsided. Long-haul syndrome,
or long Covid, is generally defi ned
as a variety of Covid-related symptoms a
month or more after the initial infection.
Common symptoms include fatigue, diffi
culty thinking or concentrating (called
“brain fog”), shortness of breath, headache,
dizziness when standing, heart palpitations,
chest pain, cough, joint or muscle
pain, depression and/or anxiety, fever,
and loss of taste and/or smell.
Cardiac symptoms are evaluated with
echocardiograms, stress tests, and other
tests. “But in most cases, there is no
structural heart damage or no malignant
arrhythmias,” Dr. Titano said. “What
happens in a lot of the patients is that
they develop dysautonomia, or nervous
system dysfunction, which leads to the
heart becoming unconditioned.”
According to Dr. Titano, it is not known
why dysautonomia develops in some Covid
19 patients, but the symptoms can
range from mild to debilitating.
“When the nervous system is dysregulated,
hand in hand we get cardiac deconditioning,”
she said. “Patients will say, ‘I used to
be a runner, but now if I just walk across
the room, my heart is beating fast and
I’m out breath’ or ‘I get so exhausted just
doing household chores.’”
Patients are treated with supportive
treatment and rehabilitation.
“We help retrain the body to not have
these exaggerated responses to being upright
and doing normal activity,” Dr. Titano
said. “Normally, blood pressure dips
a little when you stand up, so the nervous
system releases adrenaline to go to the
periphery to get blood back into circulation.
This usually happens in a split second.
But when patients have dysautonomia,
the body may not respond properly.”
Treatments can include increasing fl uid
and electrolyte intake, medications, and
a graduated exercise program to build
up the body’s reserves and train it not to
have an exaggerated response. “We start
with recumbent exercise – with the patient
lying down, which is the least stressful
on the body,” she said. “We move up
to seated exercises, then seated cardio
like a stationary bike, and then upright
exercises like an elliptical or treadmill.”
INDIRECT IMPACTS
The pandemic shone a spotlight on the
importance of going to the doctor for
things like blood pressure and cholesterol
checks and especially for symptoms
like chest pain and shortness of breath.
“One of the biggest tragedies of the pandemic
was that people were avoiding going
to their doctor, even for severe symptoms,
and it led to an increase in heart
attacks and cardiac deaths from March
through June of 2020,” Dr. Mintz said.
Many of the risk factors for adverse Covid
19 reactions are similar to those for
heart attacks and other cardiac events, and
the pandemic may have raised awareness
of the importance of taking healthy steps
to control these risk factors, Dr. Mintz said.
“Controlling high blood pressure and diabetes,
exercising, and losing weight if
you’re obese can lower your risk factors
and improve your cardiac health over
time,” Dr. Mintz said.
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