COVID-19 & The Heart

By: Abdallah Kamouh, M.D.

Over the last year, more than 110 million people were infected by the COVID-19 virus. More than 28 million of these infections took place in the United States, responsible for more than 480 thousand deaths. Although death related to COVID-19 infection spans all ages, patients with cardiovascular risk factors, with heart disease and stroke, are more susceptible to die than the general population.

COVID-19 can directly affect the heart. Patients infected with the virus can have high-grade fever, fluctuation in blood pressure, low oxygen levels and clotting of the blood. All these factors can lead to an increased risk of heart failure decompensation, heart attacks, abnormal heart rhythm and cardiac death more so in patients with underlying heart disease.

Given the threat of COVID-19 infection for patients with heart disease, the Centers for Disease Control (CDC), the American Heart Association (AHA), and many other national heart organizations encourage patients with heart diseases and stroke to take the COVID-19 vaccine.

Some people have expressed concerns about taking the vaccine. Science and medical experts and national medical associations are confident that the benefit of vaccination far exceeds the very small, rare risks. Trusted scientists and medical experts have worked tirelessly to develop and test these vaccines using the highest standards, and every step of each trial was carefully reviewed by independent experts at a common safety monitoring board and by the Food and Drug Administration (FDA).

Both US FDA-authorized vaccines (from Pfizer-BioNTech and Moderna) have shown to be very safe and demonstrated 95% effectiveness. In the initial studies before the approval, there was no apparent cardiac side effects in thousands of studied subjects. There was no difference in side effects from the vaccines between young patients and patients 65 years and older, or those with heart diseases.

Since the approval of two COVID-19 vaccines weeks ago, more than 45 million Americans have received the vaccine. Many of these patients are above the age of 70, and many with heart disease. Observations have shown no new cardiac or severe side effects in those who received the vaccine. Other than the vaccine's common side effects, similar to those seen with flu vaccinations (headaches, joint and muscle pains, pain at the injection site, fever and chills), few and rare cases of severe allergic reactions were reported and treated rapidly.

If you have heart disease and are scheduled for a vaccine, it's essential to continue to take your medications as usual before and after the vaccine is given. This includes patients taking blood thinners. It is recommended that you let the person giving the vaccine know that you are taking blood thinners so they can add a minute or two of pressure on the injection site to prevent excess bleeding. You will be asked to wait for 10-15 minutes in a waiting area after vaccination, according to the protocol, to recognize any immediate side effects.

As a general rule, if you are concerned about getting the vaccine because you have cardiovascular risk factors, you should make sure to discuss your concerns with your heart doctor.

Dr. Abdallah Kamouh is an interventional cardiologist at MUSC Health - Cardiology. For more information or to seek cardiac care, call 843-674-4787, or visit muschealth.org/Florence.