Doctor checking patient's heart

The COVID-19 pandemic put a strain on people with cardiovascular conditions.

People with existing medical conditions — like cardiovascular problems — are at greater risk of COVID-19 complications. And according to the American Heart Association, many COVID-19 survivors may suffer heart damage — even if they don’t have a heart condition.

But COVID-19 also had an indirect effect on people’s cardiovascular health in the form of delayed care. Because of the pandemic, many put off cardiovascular care. This led to later diagnoses, sicker patients, and more deaths from cardiovascular conditions.

“A lot of patients who decided to come back into the office were far sicker than what we had really noticed before,” says Aryan Aiyer, MD, medical director, UPMC Heart and Vascular Institute Lipid Clinic.

Heart health is critically important during the pandemic. It is crucial to monitor your symptoms and get care from your health team.

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Cardiovascular Care and COVID-19

COVID-19 had a direct impact on many people’s cardiovascular health, with many survivors developing heart issues. But the pandemic also had an indirect impact.

Several factors may have contributed to a delay in care, including:

  • COVID-19 prevention efforts: Attempts to limit the risk of COVID-19 spread in the community led to changing cardiovascular care. Nonessential procedures were postponed or canceled, and many in-person doctor visits went virtual. That could have affected the care patients received.
  • Fear of COVID-19: Worry about getting COVID-19 may have caused people to put off care.
  • Poor nutrition/exercise habits in isolation: Because of government regulations, many people spent much of 2020 and 2021 at home. Poor nutrition and a lack of exercise while living in isolation could have caused or worsened some cardiovascular conditions.

“Even subtle symptoms like a slight gain in weight for a patient with heart failure could be the beginning of something ,” Dr. Aiyer says. “We lost opportunities to take care of that early on.”

A June 2020 global survey of health care providers by the European Society of Cardiology found a significant drop in the number of heart attack patients who sought care at the hospital.

According to the survey, the number of people who sought urgent hospital care for a heart attack dropped more than 50%. Of the people who did go to the hospital, 48% arrived after the optimal window for care.

A UPMC Stroke Institute study in 2020 found the number of people going to the hospital for stroke treatment dropped 40% after the start of the pandemic.

Delays in seeking care could lead to more severe disease — and even death.

A January 2021 study in the Journal of the American College of Cardiology found that United States deaths from ischemic heart disease and hypertensive disease increased after the pandemic began. Delayed care was one possible reason for the increase.

“The delay in care, for whatever reason, has led to people coming in sicker,” Dr. Aiyer says.

Maintaining Your Heart Health During COVID-19

There are several ways you can maintain your cardiovascular health at all times, including during COVID-19.

Self-monitor your cardiovascular data

Keeping an eye on important heart-related numbers can help you recognize if something is wrong.

  • Blood pressure: A blood pressure reading below 120/80 is considered normal, according to the American Heart Association. Consistently elevated blood pressure could be a warning sign. Dr. Aiyer recommends buying a blood pressure cuff and checking your blood pressure twice a week. You can share your results with your doctor. “Blood
    pressure, and blood pressure control, has been a key factor in terms of
    extending longevity,” Dr. Aiyer says.
  • Heart rate/arrhythmias: For most adults, a normal resting heart rate is between 60 and
    100 beats per minute, the American Heart Association says. Heart rates can be higher while exercising. Heart rates that
    are too low, too fast, or irregular can be a sign of arrhythmia, which could be
    serious. Many wearable devices can help you track your heart rate. If
    you notice changes, contact your doctor. “Those devices allow patients
    to do some monitoring on their own so that care is not delayed,” Dr.
    Aiyer says
  • Weight gain: It can be a sign of trouble for people with existing conditions. Dr. Aiyer says keeping an eye on your
    weight — and making diet or exercise changes based on what you see — can be
    valuable.

Keep up with blood work and screenings

If you have an existing condition, you should maintain regular appointments with your doctor. Blood work measuring cholesterol, blood count, glucose level, kidney function, and more can provide important information about your overall health.

Cardiac tests and screenings — echocardiograms, cardiac MRIs, stress tests, and more — are also important if you have a diagnosed condition or if you are experiencing problems.

Pay attention to warning signs

Heart and vascular disease can cause many different symptoms. Although a heart attack can happen quickly, there can be warning signs that something is wrong.

Some typical signs of heart and vascular disease include:

  • Chest pain or discomfort
  • Chest palpitations (heart beating too fast or irregularly)
  • Pain or discomfort in other areas of the body, including arms, back, neck, jaw, or stomach
  • Shortness of breath
  • Nausea/vomiting
  • Lightheadedness
  • Cold sweat
  • Fatigue
  • Extreme anxiety
  • Fainting or loss of consciousness
  • Pain, numbness, or swelling in legs, ankles, or feet
  • Skin discoloration
  • Gangrene

Chest pain is the most common heart attack symptom in both men and women. But women are more likely to experience some of the other common symptoms. Those include pain in the jaw or back, nausea or vomiting, and shortness of breath.

If you experience any of the symptoms listed above or anything else unusual, call your doctor.

Stroke warning signs

You should also be aware of stroke warning signs. The acronym BE FAST can help you know what to look for:

  • Balance: Sudden loss of balance.
  • Eyes: Sudden double vision/vision loss.
  • Face: One side of face drooping.
  • Arms: Numbness or weakness in one arm.
  • Speech: Slurred speech.
  • Time: Call 911 immediately if you notice these symptoms.

Other symptoms of stroke include a sudden, severe headache or sudden confusion.

One-third of stroke patients previously had a transient ischemic attack (TIA), or ministroke. If you or a loved one experience a TIA, call your doctor.

Providing Safe Care at UPMC During COVID-19

Dr. Aiyer says concern about COVID-19 is understandable. But it’s still important to get the care you need for existing health conditions, including cardiovascular problems.

“It is still safe to come to the doctor’s office, get evaluated, and be seen, especially if you have symptoms or risk factors,” Dr. Aiyer says. “That delay in care could lead to a situation where you’re more susceptible.”

At UPMC Heart and Vascular Institute (HVI), we are committed to providing you the care you need while keeping you safe from COVID-19. We are taking steps to prevent the risk of COVID-19 spread. We require facemasks in all UPMC facilities and are following other preventive measures like physical distancing and sanitizing.

We also encourage patients to get the COVID-19 vaccine. You can schedule an appointment to get the vaccine from UPMC by visiting Vaccine.UPMC.com.

For more information on the HVI or to schedule an appointment, call 1-855-876-2484 or visit us online.

Sources

American Heart Association, Target Heart Rates Chart. Link

American Heart Association, Understanding Blood Pressure Readings. Link

American Heart Association, Warning Signs of a Heart Attack. Link

American Stroke Association, Stroke Symptoms. Link

Guilherme Pessoa-Amorim, MD, Christian F. Camm, BM BCh, Parag Gajendragadkar, MD, European Heart Journal - Quality of Care and Clinical Outcomes, Admission of Patients With STEMI Since the Outbreak of the COVID-19 Pandemic: A Survey by the European Society of Cardiology. Link

Rishi K Wadhera, MD, Changyu Shen, PhD, Suhas Gondi, et al, Journal of the American College of Cardiology, Cardiovascular Deaths During the COVID-19 Pandemic in the United States. Link

Laura Williamson, American Heart Association, What COVID-19 Is Doing to the Heart, Even After Recovery. Link

U.S. National Library of Medicine, Warning Signs and Symptoms of Heart Disease. Link

About Heart and Vascular Institute

The UPMC Heart and Vascular Institute has long been a leader in cardiovascular care, with a rich history in clinical research and innovation. As one of the first heart transplant centers in the country and as the developer of one of the first heart-assist devices, UPMC has contributed to advancing the field of cardiovascular medicine.