In a new study, researchers found that 18 patients with severe COVID-19 treated at a New York City hospital showed the classic signs of a heart attack on their electrocardiograms.
But more than half of these patients didn’t have a blockage in a major artery, the typical trigger of a heart attack.
Thirteen of the 18 patients died of cardiac causes while in the hospital.
These findings suggest that there’s something about the stress of severe COVID-19 that may be harming the heart in different ways.
The real underlying cause for some cardiac deaths in these patients may be the stress, physical and otherwise, caused by COVID-19, according to the team.
The research was conducted by a team from the New York University Grossman School of Medicine.
The team looked at the cases of 18 patients admitted with COVID-19 whose EKG readings indicated they had experienced a heart attack.
The EKGs displayed a classic “elevated ST-segment” reading that’s indicative of heart attack, the doctors said.
Ten patients displayed ST elevation at the time they were admitted to hospital, while eight others showed it during their hospital stay.
However, based on coronary angiography scans and/or cath-lab investigations, 10 of the patients (56%) were found to have “non-coronary myocardial injury”.
This means a heart attack that was not caused by a blockage in an artery.
The team says COVID-19 might injure the heart through a range of causes, including a rupturing of plaques in blood vessels, injury due to poor oxygenation, coronary spasm, tiny clots undetected by angiograms or more “direct” injury to vascular tissues.
This means using the standard heart treatment—clot-busting drugs—may sometimes be useless in these patients, as half of them may not have major blockages.
Researchers noted that similar findings were observed for Chinese COVID-19 patients who experienced heart crises during their care at hospitals in Wuhan, the original epicenter of the pandemic.
Besides the formation of dangerous clots, severe COVID-19 also can stimulate the inflammatory system causing a cytokine storm— an out-of-control inflammatory response to infection—which can lead to more organ damage, whether it’s the heart, lungs or kidneys.
One author of the study is Dr. Sripal Bangalore, a professor of medicine at NYU Langone Health.
The study is published in the New England Journal of Medicine.
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