Can COVID-19 damage the heart?

As you all know we are in the midst of the COVID-19 pandemic and whilst we know the virus predominantly affects the lungs there have been several reports that it can also damage the heart and a lot of people have written to me to ask to try and clarify what i understand about the virus and its effects on the heart.
The first thing to say that we only have limited data at the moment and our understanding of the virus, how it behaves and most importantly the long term consequences of being infected with the virus are extremely limited. This particular virus has only been in existence in humans for 5 months so our understanding of it is constantly evolving. What I tell you today may completely change tomorrow as more research is done. I can tell you what we know about it as things stand.
COVID-19 and heart damage
Several studies from China have suggested that patients with active COVID infection also have troponin elevations suggesting a degree of myocardial injury. The studies are mainly from hospitalised patients who by definition are sicker than patients who are not in hospital. In these hospitalised patients anywhere between 7-28% patients are found to have elevated troponin levels.
The likelihood of finding elevated Troponins is greater in those patients who are sicker and in general those who have die.
There was a study of 416 patients from china which found that 20% of patients had elevated troponin. Those patients were older. They had greater burden of comorbidities (diabetes, high blood pressure, already damaged hearts etc) and they had more severe lung disease and in general were much sicker. The mortality rates were super high -51% compared to only 4.5% in patients who did not have elevated troponins. In fact if the troponin was high when the patient was admitted then the risk of death during that admission was 4x higher.
So clearly very concerning data. However from these studies, it is not clear whether there was something about the virus that directly attacked the heart and therefore caused the injury of whether it was indirect effect of the virus and just the stress caused by the sick state that caused the already preexisting condition to flare up and complicate the patient’s disease course.
Why is this important to figure out? I suppose it is important to know this because if the virus directly attacks the heart in some way then it may cause adverse consequences in young otherwise healthy patients who have very minimal respiratory symptoms such as progressive heart failure or heart rhythm disturbances in which case one could make a case for testing everyone, doing these tests on everyone and if evidence of heart damage on echo is found then early initiation of treatment to stop heart function deteriorating can be started.
Let’s look at some mechanisms by which the virus could cause heart damage:
Viral myocarditis - in this scenario, the virus would directly enter the heart muscle and start causing inflammation and damage to the heart muscle.
Is this possible? Maybe - because the ACE2 receptors that exist in the lung which are known to be essential for the virus to get into the lung also exist in the heart.
Is there any evidence to confirm this? No. To confirm this you would have to take a bit of heart muscle and study it under a microscope to see if you could actually see the virus. Now not many people do this because it is a highly invasive test but in the exceptionally few patients in whom a biopsy has been done the virus was not visualised.
Hypoxia - Obviously the big problem with the virus is that it makes the lungs wet and very stiff and this means that there is difficulty in getting oxygen into the bloodstream. In addition the stress of the virus on the body will cause the heart to work harder so the demand is increased and the supply is reduced and therefore sheer lack of enough oxygen in the absence of any underlying heart disease could also cause heart damage.
Stress cardiomyopathy - we know from our patients that sometimes when the body is under extreme stress such infection then there is such a massive release of stress hormones that the heart can become almost a little stunned and there may be a rise in troponin and the heart can look very weak on an echocardiogram. The good news is that once the stressor has been removed the heart does tend to recover in a majority of patients.

[@betzib8021]

This is the most wonderful doctor. I cant believe he actually thanks US for listening when he is the one taking the time and trouble to help us.

[@lilianflynn198]

Who were those ignorant /uneducated ones with thump down??...The amazing knowledge that this doctor is imparting at his own will should Never be sniffed at But you do get some ungrateful souls out there ....Thanks doc You are amazing and I appreciate your dearly

[@yogiyogesh815]

betzi b He's so humble and modest ....

[@marylouirick7316]

My co worker told me his heart was beating real hard😔 His age 66yrs. He died 3days later. I take my meds and pray DAILY.

[@maltimoto]

was it related to Covid-19?

[@ykalantzis]

If you ever new how many people you have helped...With all the invaluable videos and your smile....

[@jimwilleford6140]

Yiannis K A true healer.

[@racehorse1n.c.111]

We love your intelligent and kind words. Please please stay safe. Cheers from. North Carolina. USA. .

[@valerieobrien5521]

That was very smart ! As you said... medical knowledge about this virus is as yet ... limited , so this must alsob mean that the way the body REACTS to the innoculation , must also be indeterminate ?

[@smallfootprint2961]

@@valerieobrien5521 I asked the nurse how long is the vaccination good for, and she said they don't know. I figured, but wanted to see if she had any further info. I understand some people not sure of the shot, but none of us knows, so we have to do some things on trust. More will be revealed... It beats getting the virus.

[@pattyoxley1887]

Hi Doc. Really enjoy your videos. As a retired acute care telemetry RN in the States, I really appreciate that you are sharing your knowledge and especially appreciate your demeanor. You are very kind and calming. Stay safe!

[@telephassarose3501]

Thank you so much for finding the time to give us this important information, & bringing us up to date on what we do know. I hope your exemplary attitudes are sustaining you through this challenging time...I’m sure they are, as you still seem so calm & clear, & your lovely sincere smile is still there. Keep safe dear Dr Gupta.

[@smallfootprint2961]

You're grateful? We're so grateful! Thank you for taking the time to inform us a little. I am 82 and have a pace maker. Things don't feel right most of the time, and I feel I'm not heard, but have learned to not complain. Your videos help a lot.

[@008donatella]

Blessings to you doctor, great information! Thank you!

[@christinemay859]

Thank you Doctor Sanjay Gupta, for describing so thoroughly the intricate details of the heart as related to the covid19 virus. I wish the cardiologists I have seen had the humble manner and ability to communicate as you do.

[@teddybear3552]

Dr Sanjay - Thank You for taking your valuable time to once again, re-assure people at this particularly difficult moment. Just seeing you, hearing you makes me feel safe...

[@Josh-pe5pl]

You explain things so clearly. Few diversions and if you do, you tie them to your message and get back on point. 🌺

[@jbrous3602]

You are my medication, you are the doctors visit one could never get from a establishment doctor...Thanks! Truth, honesty, integrity, Thanks again.

[@duanedelperdang1749]

Thanks again for another very informative and well spoken video. I wish you were my Cardiologist.

[@patriciaperreca2895]

This was excellent, as always relevant & on point.

[@TheDrewstar1]

I think your the best and no alarm specialist for the heart I’ve ever listened to God Bless you I was diagnosed with very high blood pressure and harden walls cardiomyopathy I was very scared and feeling very down you have made things a little better just watching your videos Drew

[@jimmiepatrum]

This doctor has such a wonderful way of explaining what I'm sure are complex heart problems in a down-to-earth way to we uneducated. Diane in NC

[@sfnny5135]

Thank You FRONTLINERS.

[@riteasrain]

Thank you for having the transcription of the video in the description. Very handy timewise 👍

[@Ranee1866]

Thx for this valuable information Doc👌..ur one of the best when I feel lost with my health.

[@kausikroychowdhury1859]

Thanks a ton for sharing your knowledge with the world! Stay blessed!!!

[@Ateeq303]

I work as a scribe for an American EP doctor based out of India, your videos are so helpful. Thank you so much for such details.

[@YorkCardiology]

Glad it was helpful!

[@capyboppy]

Another brilliant down to earth video Sanjay. God willing when this is all over you will be able to do another seminar in York or even better; Manchester. Hugs, strokes and a 'virtual bone' for Bluebell.

[@janicemillican9754]

Thank you for helping us understand this awful disease.

[@kathyd7546]

Thank you for so much information, Doctor. When you have time, could you do an updated video about covid and the heart? What do we know now and what have you learned over the past couple years? Thank you again! Your videos help so many people and your passion to help people is enlightening.

[@NyleLynn]

I am in NYC. I had no preexisting conditions but I suffered through COVID symptoms and I just had a irregular EKG with possible myocardial issues so now I have been referred to a cardiologist. Thank you for this video! I was very confused as to why or how this could have happened and now I will be going into my next appointment with an understanding of what the doctor is talking about.

[@itsjen94]

What happened at the cardiologist

[@veramentegina]

thank you for clarifying all this in such an articulate manner. you are the best!

[@carolbenson6524]

Thank you thank you thank you so much for answering questions on this! I've been worrying about this for a while.

[@suewright1299]

Very many thanks for such an amazing explanation Mr Gupta, you are truly marvellous! Please don't feel you need to be grateful to us, it is we who will be forever grateful to you! ❤️

[@YorkCardiology]

So nice of you

[@maltimoto]

There was some video from a guy who had Covid and even weeks after the infection, his heart rate went up to 120 even if he only left the house and walked 10 meters to his car. Really frightening!

[@Angiedisney14]

That’s like me lol

[@richt6353]

Thank you Doctor for your excellent information!

[@bikkyychaudhry4510]

Stay Safe Everyone.

[@sowmiyaskitchensowmiyaraja8016]

Informative Video and as always very helpful. thankyou and may god bless you

[@dannykl6883]

Excellent information, thank you ... The battery had run down on my pacemaker I had it changed at Papworth last week... excellent treatment as usual I was in and out in four hours the NHS is magnificent!

[@pamelaatkinsonscats2873]

Your videos are always so helpful and I just enjoy listening to your calming voice. Thank you very much, Doctor.

[@larsjoppich]

Thank you Sanjay for all of this information! As you said the information you had when recording this video was very limited. I would really love to see a update on this topic with data available now, more than one year later. (Does covid still doesn't directly attack the heartmuscle etc.?)

[@Ski7440]

Thankyou Sanjay ,, ur a godsend to this nation especially.. This video was so interesting ...thanks ...I’m just glad my poorly father who had heart failure isn’t here anymore to catch Covid, because we wouldn’t have been able to be there with him to nurse him and say our goodbyes. Luckily we could, 🇬🇧stay safe stay well Sanjay 🙏🏼👏👏👏🇬🇧

[@alsci2489]

Same with my dad who passed 18 months ago.

[@PAFinch]

Brilliant video with life saving information. Thanks!

[@marisolcoralesreviews1559]

Thank you for the generous information doc. I accidentally saw your channel while researching about IRBBB which I have based from the ECG and Stress Test. Since then, I have been watching your videos. God bless you.

[@snowy_cinematic]

Thank you very much for your great information, as always 👍👍👍

[@DaisyAnnabelle65]

Thank You Dr. for all of the updated information you give the public!

[@bm_1979]

Hello Doc! Thank u for the helpful and useful info♥️😇

[@jimwilleford6140]

Doc. You remind me very much of out now famous Sanjay Gupta here in America on television. You have such similar countenances of kindness and share your wonderful scientific data, garnered by many years of education.

[@asphaltcowboy7567]

He seems nice. But it's a fortune to talk to him on the phone etc. I no he has to make $. Buts its crazy expensive.

[@angelacross2216]

Thank you. Very clear and reassuring information.

[@lisapackingham2820]

Thank you so much Dr.Sanjay Gupta ❤️

[@hrobert745]

I hope you can do an update video about COVID and the heart, including any effects in long COVID.

[@MillieMillie33]

Excellent video. Very well explained. Many thanks.

[@bubbarand2561]

An excellent communicator. Thank you.

[@TuneInWorld]

Thank you for this. I was up worrying about my heart as my troponin is elevated after covid, and you gave me some hope with the explanation.

[@carolbenson6524]

Do ventilators put too much pressure on the lungs and heart? Just wondering because so many people placed on a ventilator are dying. That's what scares me!!

[@terimurphy4009]

Thank you so much Dr Sanjay. Your videos are so informative and easy to understand. Big gratitude from Cape Town

[@kimberlywallace4514]

Thank you very much for your time to share information with all of us.

[@lilianflynn198]

Is like having my own cardiologist Thank you

[@jolyndaj]

Please stay well and thank you for all that you do!!!

[@toyintoyotacamry]

I've been watching your videos everyday and I must say you are simply amazing. You are God's gift to mankind. God bless you Dr.

[@Charles_S.]

Thank you as always for you sharing your knowledge

[@suecondon1685]

Thank you Dr Sanjay for your expert insight, very helpful as always.

[@SS-ty1gr]

Hi Sir Thank you for the valuable information what about arrythmia patients who are suffering with SVT POTS,PSV,Techycardia and Bradycardi

[@shamilaraji2627]

Thank you so much dr. Gupta, for this video.would there be a new video on this subject, since the pandemic has progressed this far.may you be blessed for doing what you do.

[@RACING5312001]

What's you view on smart watches particularly with regards to heart rate monitors especially the Apple watch and it's ECG function? thanks

[@glennhosick1514]

Hello Dr Sanjay. I have meant to write a comment. On your page for some time now. I believe today is very much an appropriate day! With my reasoning to follow. .... I happened across your vloggs Dr Sanjay. Quite some time ago now. I watched them with both an interest! & fascination! Subscribing immediately! As I concluded rapidly. Through my own natural insight. You are quite simply. A beautiful human being! ..... "My thoughts @the time". Here is a man preforming life saving! Life enhancing Surgeries! & Clinics on a daily basis! Yet here you are also. Giving freely your time! Your intuitive advice! Providing sound clinical Information! Which in turn. Could lead in helping other human beings. Take charge of their own destiny! & An ability with which may lead them to enhance both their quality of life! & life expectancy! I was absolutely in awe of both your blessing! & Indeed your gift! Then whilst I thought your soul! Could not shine any brighter! Dr Sanjay. Your kind! caring! selfless nature. Your Intelligence. & Empathetic soul came to the fore furthermore. In the substance of your vlogg. Titled. *Baby Elephant* This was just a further optimizer in what a beautiful human you are! As i also believe empathetically! All animal's & creatures a like. living! & breathing! Deserve a life on this planet in their own natural habitat. Or other! As predetermined by Nature's precursors. In my mind. We are Custodians of this beautiful Planet! whilst we are here It is our duty! To endeavor to sustain a better existence for all! Instead of taking these beautiful animals to the brink of extinction! In the name of greed! Sport! or other! I love all animals! Though would be a tad biased! @#lovedogs! Humans best, blessed friend! & teacher!🐕🐕🐕🐕💜💜💜💜. when I look at the Siberian Tiger! I see such a Majestic beautiful animal! Such a powerful life form. Also aptly named. The Ghost of the forest! Which resonates with me. "A maverick"! Yet sadly another blessing! Which makes up the endangered list. My reason for writing this comment today. Is simply this. I was woken this morning just after 05:00hrs. To Paul Hayes. Magic radio presenter. Informing listeners! It is National Save The Elephant day! Hence Dr Gupta's vlogg Came to mind. So when we come together this evening! in giving thanks! I send you a personal thank you! May you be blessed Dr Sanjay with good health! & long life! To continue your vastly appreciated work! This extends. To all the beautiful souls!💜 Who are giving so much! In an effort to sustain the Lives of as many human being's as possible. With both a Courage! & A selflessness unparalleled! #blessed we our! 💜💜💜💜💜💜💜💜💜💜💜💜

[@YorkCardiology]

how kind thank you Glenn!!!!

[@markb1487]

Fantastic video,,, I wonder if you know anything about a condition called JAK 2??

[@cuisineallfuntravelnetwork8615]

Nice to hear and see you doc! Hope you are safe also and all of us ! God bless us all

[@YorkCardiology]

Thank you so much!

[@cuisineallfuntravelnetwork8615]

York Cardiology can I get your email ?please

[@YorkCardiology]

@@cuisineallfuntravelnetwork8615 [e-mail]

[@tfm_patrick]

Thank you so much for making this video, I’m very great to you

[@Stardust12397]

Such a great communicator you are

[@soobowteedasrut7051]

Thank you for the knowledge Doc

[@judyly7375]

Can we get an updated video on what we know now on heart damage and COVID-19?

[@mareejones6281]

Excellent explanation. Thank you.🙂

[@SuperMikeAttack]

Do we have any updates on this information a year later? I just went through my second Covid infection and I'm pretty concerned about this subject.

[@eternal_nomad]

Me too

[@aphysique]

It's always a concern..especially when it cause long term symptoms..fatigue suxx

[@Beatriz-xd1nv]

Very well explain how the virus can flare or attack the heart muscle of the person infected , thank you for sharing your knowledge .

[@blb11291]

Great info. Thank you so much.

[@lamarduarte9681]

I started having some irregular heart issues and have consulted with several doctors. Doctors have much knowledge but not necessarily the time or compassion to explain with such detail as Dr. York. We are blessed to have access to his information and experience. People are dying by the 1000's and I believe any possible medications are worth trying.

[@rabens02]

Have them check your potassium levels. Covid 19 causes continuous potassium loss during infection. Potassium is necessary for heart conductivity. You can start by increasing potassium rich foot to see if that helps but go in and have your blood levels cheked.

[@isabelcasillas4856]

Informative, thank u! Stay healthy.

[@michellekulas282]

Thank you for this video. My daughter (now 17) had viral myocarditis three years ago. She had a common cold caused by a coronavirus at the time of her ICU admission, but her cardiologist did not know if that was the cause. Her ejection fraction was in the low 40s and her troponin level got as high as 29. She had IVIG and some other medications, and she’s now completely back to normal. I am very concerned that this illness could affect her heart again, so we are taking every precaution to not bring the virus into the home.

[@rabens02]

Michelle watch for symptoms of low potassium if she exhibits symptoms. This has potential to affect the heart and is a side effect of covid-19 and no one is talking about it. Bump up potassium rich foods if concerned.

[@leona5508]

I’m sixteen and have been having shortness of breath and palpitations. No one will listen to me :(

[@vl2663]

Leona me too :/ how are you feeling now?

[@omargonzalez6971]

Hi how long did it take your daughter to heal?

[@yogiyogesh815]

Michelle please encourage your daughter to include FISH in her diet , the EPA, DHA, OMEGA 3 , VITAMIN D3 and ASTAXANTIN which is found in fish and Krill oil has been found to very beneficial to the heart !

[@eternalharmony5420]

Good explanation. Thank you.

[@hemiv8949]

This is one awesome cardiologist, I wish he was my next door neighbour.

[@Angiedisney14]

I had covid 19 in November 2020 in uk, I have since been diagnosed with hyperthyroidism and Graves’ disease. I have had evolving fast rhythm to now irregular rhythms and getting more tests done this month but been living with this since December pretty much last year it’s just horrible I’m only 29 and female

[@whyaskwhy2238]

Dr. Gupta, your explanation for a layman is excellent. Do understand there is so much information that need to be put in a short span of time. However, good to be well informed. Couple of questions , is there any evidence where the C.virus attacking or attaching itself on the narrowed arteries/ plaque. Obviously patients waiting for bypass surgery must be in a very high level of risk. For people with diabetes, does the virus have any increased attraction towards high blood sugar. Virus with a sweet tooth :) Lastly, what would be your advise to someone who is diabetic with high bp awaiting a bypass? If there are strong symptoms....does one wait it out or immediately contact hospital.

[@rebeccacoverley5823]

I have a very interesting question Citric. When swine flu was going on about in 2009 I had a mild exposure to it. Because my ex got it. Four some strange reason at the time the virus missed me. Never had any symptoms of the swine flu. What is the reason to why this happen. Even though I was told to keep out the room. He would have still been walking in down the passageway to go downstairs to use the toilet and the kitchen? Which would have still been leaving Germs About in the house

[@glgartman]

My question is unrelated to this topic. I would like to know if the Covid 19 virus can colonize within a person for an indefinite period of time, as the MERSA bacteria can (often in the nose).

[@JenJett]

Thank you dr. Great info. 👍💞

[@Ravencrowwise]

Doctor, Thank you, I've been struggling with Crushing and debilitating chest pain for years. Going for a CT Angiogram next monday. Would the troponin blood test be positive all the time after the heart was damaged that is? Or do we get to regain normal values once the angina symptoms pass.

[@wasdwecst]

Very helpful and.informative.video

[@alanwhitehead9756]

Sorry this is off topic, but what do you think of Dr Thomas Cowan's ( & Rudolph Steiner) theory of the heart not being a pump. He also has views on Covid 19 also and reports that the coronavirus test doesn't pass Koch's postulates.

[@arvindsharma2233]

Nice information sir.

[@joelhall5124]

If HLH is the mechanism behind this pneumonia, then it stands to reason there will be cardiac complications, as well as other organ damage. That said, which patients are seeing these problems, and what is their medical history? We just don't have a full picture.

[@dawnschubert1]

Thank you as always!

[@daniellegloveskeanu]

Hello Dr. So I'm covid negative and have had left lung issues the past few months. Clear scans. So the pain stared traveling up to my heart and chest wall on the left. So I was sent to a heart Dr. I live in Rochester NY, in case you are wondering. My name is Danielle and I'm 40. I am currently at Westfall Cardiology in case you want to peek army case. I was diagnosed with left atium moderately enlarged. So yesterday I went to have a nuclear test done because my heart hurt at the incline. About 1 hour after the test my chest and lung started feeling better. Today I feel great. Not 100% perfect but about 70% better. I can't explain it. I really think the radio active material helped whatever was going on. I still have to have a bubble study done in a few days. I can take a deep breath in and my left lung doesn't feel like it did yesterday. No icing my chest wall on and off daily either. No ice today. I wanted to share this. Ok bye. 😁

[@dcbrit2003]

Can we have an update? It's now 7 months later and so we now have 7 months more data

[@commons9351]

Many thanks to Dr Sanjay Gupta for this information. KZbin is vital at the moment, especially now GP surgeries seem to be unapproachable in the UK - do appreciate they are dealing with a global pandemic! I have a slightly off-topic question: I have self diagnosed Afib and my question is: does Afib alone make you five times more likely to have a stroke, or do other health issues need to be present, as per CHADS2 - in the absence of other conditions can Afib largely be ignored?

[@funnynickline]

It is really essential to not get infected by the virus inorder for the heart be out of stress,. so stay in their homes keep calm, pray, and do the house hold chores and planting some kinds of bananas and whatnot into their yards or vacant areas if they have, it can help lifes situation within this pandemic period😌.

[@thisandthat9710]

Excellent. Thank you!!

[@YorkCardiology]

You are welcome!

[@chestnutfillie]

Thanks for that explanation😊 my troponin level was at a 1000 when I was admitted to hospital in March this year, an echo showed damage so a cardiac mri was done & I was diagnosed with myocarditis & myocardial oedema 4 months on my levels are still at 780 & the d dimer is raised too! I was never diagnosed with covid but had a very bad flu like virus in December 2019! I havnt yet had a follow up with a cardiologist but had all my bloods done today in a medical assessment unit, what treatment will help the heart to recover please? Tia

[@kidssongschristian4143]

Hello Doctor, as always, a great video. However I wanted to know if patients with sinus tachycardia can take the vaccination. Thanks.

[@bluegigames]

cheers doc for the helpful video

[@alonzosanchez9520]

If I get pvcs when I drink caffeine am I considered to have an underlying condition? I also have diabetes but only take metformin and it's under control. Sugar level stays in the pre diabetic numbers. I'm 49 yrs old

[@Andromeda_M31]

I think had this last month and have had chest pains like heartburn for a month. I get pains going down my left arm and neck. All of the doctor's offices are closed for preventive medicine and the hospitals are only treating covid-19. I'm hoping I get better soon. I have POTS but not cardiac issues I know of. I'm getting concerned.

[@rabens02]

Covid19 causes continuous loss of potassium. Have them check your potassium levels. You can increase potassium rich foods to see if symptoms improve until you can get your levels tested. Potassium is required for heart condictivity. Look up symptoms of Hypokalemia or low potassium.

[@Andromeda_M31]

@@rabens02 I have potassium pills that relieved my symptoms. I think you are correct, my chest pains are from low potassium.

[@rabens02]

@@Andromeda_M31 Glad to hear your feeling better and it's helping. But if your symptoms worsen or fail to improve make sure and call and let them know your symptoms and that your suspect COVID-19 are are having cardio symptoms. Awareness if the cardio component will hopefully start to be more well known.

[@Quinoacooked]

Hi Dr. any thoughts on the covid Pfizer vaccine and patients with SVT , PAC and PVC with it’s rare side effects of the heart?

[@merlvinc]

Very helpful! --Bonnie Robinson

[@shazzabelle123]

Thank you so much Dr Gupta.

[@YorkCardiology]

Always welcome

[@SeaZen]

I'd love to be involved in the data research! I had it before it was a thing 12 months later I have undiagnosable heart issues troponin is the only abnormal marker in all the testing.

[@gandalfthewhite8075]

Hi, I had a Troponin test done almost a month after having covid. Would that rule out any Viral Myocarditis?

[@fahmiramzy5716]

Thank you sir for your valuable video I noticed that you have a very pretty dog Please add a new video to explain the exact role if any of pets in transmission of covid 19