post covid cardiac complications

long covid

SARS-CoV-2, better known as Coronavirus, has rapidly spread worldwide, infecting hundreds of millions of people.

However, the exact and complete long-term effects of Covid are yet to be known, and several research studies are still on regarding the same. Therefore, the information provided ahead is purely based on research studies and papers published on the same.

Since its emergence, Covid has always been dreaded as fatal and a life-threatening virus. It has the potential to damage the heart muscle, impair cardiac function, and result to post covid cardiac complications. This could be because of many other factors.

The coronavirus attaches to angiotensin-converting enzyme-2 (ACE-2) receptors in the heart before entering cells. High levels of inflammation could also be one of the reasons for heart damage. The inflammatory process that occurs as the body’s immune system fights the virus can harm some healthy tissues, including the heart.

Coronavirus infection also affects the inner surfaces of veins and arteries, causing inflammation, damage to very small vessels, and blood clots, all of which can impair blood flow to the cardiac vessels or other parts of the body. Severe COVID-19 may even affect the endothelial cells that line the blood vessels.

Technically speaking

  • SARS-CoV-2 enters cells and affects the enzyme 2 (ACE2) receptor – a multifunctional protein found in the lungs, heart, and blood vessels.
  • The associated post covid cardiac complications are most likely caused by dysregulation of the ACE/ACE2 system and comorbidities such as hypertension.
  • SARS-CoV-2 may also infect human cardiomyocytes –
  • Post covid cardiac complications may be primary or secondary due to acute lung injury, resulting in increased cardiac workload.
  • Immune system activation, combined with immuno-metabolism changes, may lead to plaque instability, contributing to the development of acute coronary events.

Some study-related observations

  • Incidences of cardiac injury (abnormal cardiac MRI) in patients with only mild COVID-19 have also been observed.
  • Patients with moderate-to-severe COVID-19 have shown signs of cardiac injury due to elevated troponin levels and decreased left ventricular ejection fraction.
  • Furthermore, ‘Collateral damage’, including acute coronary syndromes and stroke, have also been reported as post covid cardiac complications.

What about the Heart?

Should you be concerned if you had COVID-19, recovered, and now feel fine? Is it possible that heart problems will develop later in life?

It is noteworthy that SARS-CoV-2 was isolated in 2019, and the vast majority of COVID-19 survivors began to recover by the end of 2021. Hence, it is difficult to predict how the disease will affect people’s hearts in the long run, and this is just one area of great concern among researchers.

Many Health research centers are collaboratively working with dozens of academic medical institutions to monitor the health of COVID-19 survivors. Study groups are pooling patient data to better predict the post covid cardiac complications.

In short

COVID-19 patients or survivors are at an increased risk of developing cardiovascular disease in various ways, including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, etc myocarditis, heart failure, and thromboembolic disease.

Post covid cardiac complications – Specific symptoms may include fatigue, palpitations, dizziness, chest pain, and shortness of breath.

 A detailed snapshot of Post Covid Cardiac complications


● Ventricular fibrillation, ventricular tachycardia, atrial fibrillation or flutter, or heart block

● Related to hypoxaemia, cytokine storm and acute illness

● Long-term consequences not well defined but palpitations are a very common post-acute COVID-19 symptom

Cardiac complications

 Deep-vein thrombosis and pulmonary embolism

● Coagulopathy associated with severe disease

● Anti-phospholipid antibodies small-vessel thrombosis

● Need to determine if the risk of recurrent thromboembolism is elevated, necessitating long-term anticoagulation

Left and/or right ventricular systolic dysfunction

● Can occur as a result of myocarditis, stress-induced cardiomyopathy, or myocardial infarction

● Often transient, but time to normalisation and long-term consequences are unknown

 Acute myocardial infarction

●  As a result of inflammation-related plaque destabilisation (type 1) and increased metabolic demand with hypoxaemia (type 2)

● Many cases presented late and received delayed treatment, resulting in less-than-ideal recovery and possibly worse long-term consequences.


● May or may not be linked to elevated troponin levels

● It is unknown whether the risk of complications is increased when compared to non-COVID-19-related pericarditis

When to see a doctor

Shortness of breath

This could be one of the most prominent symptoms of post covid cardiac complications. If you suffer shortness of breath (difficulty breathing), which doesn’t seem to go away, you should immediately see a doctor. However, Shortness of breath is not always a sign of a serious problem, but if you have it along with low O2 (below 92 percent), you should be concerned.

Chest Pain

Chest Pain post covid does not necessarily mean anything serious, but if the pain is persistent and is accompanied by nausea, shortness of breath, and lightheadedness, then you must get in touch with your doctor.

Role of EECP treatment in managing post covid cardiac complications

Enhanced external counterpulsation (EECP) treatment improves symptoms such as fatigue and breathing difficulties in patients with “long COVID.” It is an FDA-approved outpatient therapy. It improves blood flow in people with long-term heart disease symptoms such as chest pain and pressure by applying pressure to the lower limbs.

According to new research, long COVID is specifically related to post covid cardiac complications or disease that affects vessel health, also known as endothelial function. EECP is a disease-modifying, non-invasive therapy that has previously been shown in controlled clinical trials to improve endothelial function.

Several of the patients were so disabled that they couldn’t even work. Surprisingly, all patients successfully returned to work after undergoing EECP treatment. These patients also experienced less fatigue and ‘brain fog,’ which is a common side effect of long COVID.

At PPCC, in Pune, patients undergo 35 hours of EECP therapy. This treatment is given for a total of 7 weeks, five days a week, for 1-2 hours per day. Our patients experienced significant relief from heart block symptoms following this comprehensive non-invasive procedure, and they were able to resume their normal activities in no time.

Consult us today for further info on how EECP therapy can be advantageous over other treatments for post covid cardiac complications.

What can be concluded?

As the covid pandemic continues to wreak havoc all around the world, this arena remains an area for further study and observation. Much learning is yet to happen concerning long covid effects, and there are no definite answers. Nevertheless, as there are pieces of evidence about Covid causing somewhat distress to the cardiovascular system, any symptom experienced should not be ignored by covid survivors and must be reported immediately.

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