Colorado Springs Cardiologist discusses how COVID has affected patients

COLORADO SPRINGS, Colo. (KRDO) - February is American Heart Month, creating a time for people to think seriously about their cardiovascular health. According to the Centers for Disease Control and Prevention, heart disease continues to be the leading cause of death across the United States, taking 696,962 lives a year.

Unfortunately, coronavirus is now adding to the heart issues Americans have endured over the last two years, and continue to experience right now.

KRDO recently sat down with Dr. Brian Metz, a Cardiologist at Colorado Springs Cardiology, who explained how the pandemic is taking a toll on our hearts.

There’s been a lot of illnesses that have taken a back seat during the pandemic because COVID has taken precedence, and people have avoided their annual checkups. Is heart disease or heart problems something you’ve seen fall into that trap?

"No, we've been quite busy with during COVID. There are a lot of arrhythmias associated with COVID. We do see cases of myocarditis or inflammation of the heart muscle, although not frequent. The worst complications we've seen with COVID have been blood clots that can either form in the heart, we find them on ultrasound, or which appear in different parts of the body. The blood clots can also involve the heart arteries and cause a heart attack-type syndrome. It's very difficult to treat because the arteries can be completely plugged up with blood clots.”

Do people have symptoms before they come in to see you? Or are these problems people don’t know about until a doctor can take a look inside?

“When patients come in with blood clots in the heart arteries related to COVID, they typically have the same presentation as a heart attack from more typical means, because blood clots form in heart arteries usually when a piece of plaque ruptures and a blood clot forms. But when you have a blood clot with a typical heart attack, it's usually more focal in the heart artery, and not as diffused as what we see with the blood clotting disorder commonly found with the COVID syndromes.”

These heart issues that you’re seeing those who battled COVID, are they typically older patients or are there younger ones too?

“We're seeing coagulopathy as our blood clotting problems in people of all ages, and surprisingly young patients. It depends on how the body responds to COVID, and the immune system can often cause an unusual coagulation problem and that makes fairly young people who wouldn't have ordinarily had blood clots in their heart arteries come in with blood clots.”

Is this found in people who had severe COVID? Or do you also have patients who were mild or asymptomatic, but then developed issues later on?

"It's usually those patients that are coming in with severe COVID. They usually have significant lung involvement and other organs, including the kidneys.”

New research shows ‘Broken Heart Syndrome’ is disproportionately affecting older women. Is this something you’ve seen or are worried about?

“This dates back to 1990, when the Japanese brought out a term Takotsubo cardiomyopathy, where they described a heart having an apical ballooning that looked similar to an octopus trap, or a Takotsubo. It took a while to figure out exactly why this was happening to post-menopausal females. 90 percent of these cases occur in post-menopausal women. Over time, it became more clear that this was a catecholamine or adrenaline-based mechanism that was causing this ballooning of the heart, and a presentation very similar to a typical heart attack. Same chest pain, same EKG abnormalities, not as high of the cardiac biomarker elevations on the blood test, but the chest pain syndrome was quite severe. And on heart catheterization results, the heart arteries would look fine or not severely blocked. So it became clear that something was causing the heart to balloon out, mainly at the tip of the heart. It turns out it's due to a severe catecholamine elevation that usually is a result from severe emotional stress."

With Broken Heart Syndrome brought on by severe emotional distress, could stress from the pandemic over the last two years play a role in the rise of this condition?

"Yes, definitely. I do think the increased stress caused people to become sick with the virus, the emotions of people unexpectedly dying of the virus, the effect on loved ones in the family, the financial stresses caused by it, I do think it is definitely contributing to an increase in the number of catecholamine or stress-induced cardiomyopathies that we're seeing.”

Are there things people should look out for when it comes to heart problems or early signs of heart disease?

"I think you have to listen to your body and you can't delay seeking out medical care when you're having severe chest pain. If you're having severe chest pain, your best off coming to the emergency room. Occasionally, it can end up being from heartburn or from shoveling too much snow and hurting your sternum. But you don't want to miss something that can be life-threatening. Unfortunately, severe chest pain can often be due to a blocked artery causing a heart attack, it could be from a blood clot going into the lungs, and it can be from a stress-induced problem like we're discussing."

For people who had COVID and maybe think they’re out of the woods, should they keep an eye out for future problems that could pop up?

"Yeah, I think COVID is tricky. I think sometimes you feel like you're recovering and you're doing great and then all of a sudden your breathing gets worse, and it's possible that your lungs have had more damage than you know. So I'd say just because you're getting better within the typical five days of recovery from COVID, if things get worse later in the course, I think that's another time that you have to seek out medical evaluation to make sure things are not taking a turn for the worse."