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Infection with Covid-19 is a major health problem because it affects not only the lungs but also other organs such as the heart muscle. The virus has been shown to cause inflammation of the heart muscle, or myocarditis.

It is not yet clear whether Covid-19 causes myocarditis more frequently and whether this myocarditis has a more severe clinical presentation than the myocarditis caused by other viruses. The virus triggers an immune response in the body in an unconventional way. Survivors may be at increased risk of heart muscle inflammation. The heart is prone to inflammation from Covid-19 because of the angiotensin-converting enzyme 2 (ACE2) receptor found on the surface of heart muscle cells to which the virus binds. For this reason, several studies have been conducted with patients who had recovered from Covid-19 several months earlier and had a mild to moderate clinical presentation.

Magnetic resonance imaging (MRI) scan of the heart was performed, as the most accurate non-invasive technique for diagnosing inflammation of the heart muscle. The MRI scans showed heart involvement in 78 out of 100 patients. It is interesting to note that 60 out of 78 patients showed signs of acute inflammation 71 days after their infection with Covid-19. The study concludes that even a mild course of Covid-19 in relatively healthy people can leave a mark on the heart.

Another study examines competitive athletes. 4 out of 26 athletes from Ohio State University, USA, who recovered from Covid-19 had myocarditis.

Myocarditis can lead to cardiac arrhythmia, sudden death (during intense training), and heart failure. Therefore, cardiac examination, echocardiography, and cardiac magnetic resonance imaging are recommended 3 months after infection with Covid-19.

The recommendations of the European Society of Cardiology for patients recovered from myocarditis are to avoid strenuous physical activity for 3-6 months.

In the future, a frequent question of cardiologists will be whether you have been infected with the Covid-19 virus.

The last 8 months of life in a pandemic caused by the Coronavirus, has greatly changed our normal life and introduced new rules.

For better control of the pandemic and for your own health, taking into account all possible consequences of the Coronavirus, we recommend that you wear protective masks everywhere, and wash your hands frequently.

In addition, if you have recovered from Covid-19 infection, we recommend at least one cardiac examination, regardless of your age or the severity of your clinical presentation.

Early diagnosis of myocarditis can prevent the development of serious complications.

* Myocarditis finding using cardiac magnetic resonance (CMR) imaging

Dr. Milka Klincheva

Cardiologist