Dr. Rajiv Agarwal Discusses COVID-19's Adverse Effect on the Heart

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- It took a minute for us to figure out
all the initial symptoms from the Coronavirus when it first hit.
Now, with three years of research there could be a lingering connection
between COVID-19 and heart issues.
Here to share symptoms to look out for
and when to see a cardiologist post-COVID is Dr. Rajiv Agarwal
with Modern Heart and Vascular Institute, good morning.
- Morning, Deborah, how are you? Happy New Year!
- Happy New Year to you too.
So with COVID we obviously knew the first thing it seemed to hit were the lungs
and then a lot of people got through COVID and started talking about
this thing called long COVID and they were having all kinds of issues,
whether they couldn't taste or smell anymore.
I have one friend who says she's got this persistent back pain
that she had during COVID that will not go away.
But now we have more information to work with that really points to some heart issues?
- Yeah, you know, initially we thought that it's just a primary lung issue
but it's not, it has lots of effects on the heart.
There's several ways it affects the heart.
Number one, during the acute phase when you have COVID
you get less oxygen in your body because the lungs are flooded with inflammation,
or blood clots, or what have you.
Secondly, you can get inflammation directly in the heart muscle
and we've seen people that develop congestive heart failure
something called cardiomyopathy and the other thing is something called a cytokine storm.
And basically what that means is when you get COVID the body just attacks the viruses,
you get a severe attack from chemicals in the body that attack the virus,
but unfortunately, those chemicals can attack healthy heart tissue as well.
And that can cause a lot of rhythm problems, a lot of heart disease
that we're seeing months and years now after COVID, Deborah.
- Can that make it even worse for somebody who had existing heart disease?
- Absolutely.
They're already at risk, they have a strike, whammy already and now they get an infection
that drops their oxygen levels, that drops their heart rate, or raises their heart rate,
or affects their blood pressure, their heart function,
and these people come in really sick at the hospital.
What our goal is to avoid them from going to the hospital
and educate them about when to see their primary care doctor or a cardiologist.
- What are some of the symptoms
to look for post-COVID and how long after COVID are we seeing this?
- Oh, we're seeing them immediately, we're seeing them months later.
We're even seeing them years later.
I saw a patient this week, yesterday, who had COVID in 2019 and has been having symptoms
for two plus years now and finally came in to get checked out.
But the common symptoms that we're seeing in patients, number one, chest discomfort, number two, shortness of breath, number three, palpitations and fatigue.
So let's go through each one.
The chest pain, the key with all of these symptoms is that, are they with exertion?
So if you get chest discomfort with exertion and you rest and it goes away,
the shortness of breath, you walk to the bathroom, you walk to your car,
you're getting out of breath, don't ignore it.
And palpitations are when you feel like your heart's racing
or you feel a flutter, or a skip in your heartbeat, not to be ignored.
But most commonly still, Deborah, is fatigue.
People are living with poor quality of life and that's not acceptable.
They've had COVID, they have fatigue, they need to get checked out.
I can tell you stories of hundreds of patients that have seen us for fatigue,
we found that their heart was involved, we took care of that
and their quality of life is back to normal now.
- Some of the symptoms that you mentioned
kind of mimic having an actual heart attack.
So I know a lot of people right now are kind of freaked out,
so let's look at when you should call the doctor,
when you should probably just go ahead and head to the hospital.
When you have shortness of breath, that you talked about.
When do you call your doctor and when do you cut bait and say,
"I probably need to go in?"
- If the symptoms are severe.
So if you're seeing that you have blue lips, you're having severe severe chest discomfort,
your oxygen levels are very low, you need to get proper care.
Don't go to your cardiologist, don't go to your primary care,
that's probably the time to go to the hospital.
But if the symptoms are manageable, yes, you're symptomatic,
but it's not to the point where you feel like you're dying,
then certainly come in and see us or some cardiologist and get checked out.
The goal is to find it early and make it go away.
- So there are heart issues that we talked about related to COVID
but is an actual heart attack more likely after COVID?
- It depends.
There are two common types of heart attacks that we talk about,
there's type 1, which is due to blockages and clots, it's less likely.
I mean, I saw a 41-year-old guy recently who was a basketball player,
playing full court basketball with his three boys, he came in as a second opinion to us,
he had a 99% blockage in the widowmaker artery.
Don't tell me that he had that blockage before COVID
because he was playing full court basketball.
So it does cause type 1 heart attacks, but less likely.
More commonly are what are called type 2 heart attacks
which is from the stress of the COVID affecting the heart,
whether the heart rate goes up, the oxygen level goes down,
those are way more likely.
- Is the COVID damage permanent?
- It can be.
But you know, the key is to get screened early.
We're learning more and more about this.
My message to the audience today would be, is that,
if you're having symptoms please don't ignore them,
please don't say that, "Well, they'll go away on its own,
"it's something I ate."
If you've had COVID and you're having any of these symptoms please get checked out .
There's so many patients that we've been able to bring back to normal quality of life
because they didn't wait.
- And of course, Dr. Agarwal, we know that heart attacks are the number one killer
of men and women around the world, at a certain age if you just get checked out, period,
whether you've had COVID or not,
because oftentimes the first sign of an actual heart attack
is the actual heart attack.
- Exactly, you're right.
So I would encourage our audience if they're 50 and above get screened regardless.
It's like getting a mammogram on time for women, get screened on time
and if you're diabetic or have strong family history start even earlier, it could save your life.
- Thank you, Dr. Agarwal.
- Thank you, Deborah.
- To book an appointment with a board-certified cardiologist at
Modern Heart and Vascular Institute visit them online at
modernheartandvascular.com.
You can also call them at this number, it's 832-644-8930,
again, that's 832-644-8930.
They accept most major insurances including Medicare.
Appointments fill up fast so contact them today.
And by the way, they have doctors who are fluent in Spanish as well.
It only takes a minute to schedule a heart screening
and that could, as he said, "Save your life."