Coronavirus symptoms similar to heart attacks in patients, say doctors

The 64-year-old patient arrived at a hospital in Brooklyn with symptoms looking like those seen in patients having a serious heart attack.
 

An electrocardiogram revealed an ominous heart rhythm. The patient had high blood levels of a protein called troponin, a sign of damaged heart muscle. Doctors rushed to open the patient’s blocked arteries — but found that no arteries were blocked.

The patient was not having a heart attack. The culprit was the coronavirus.
 

The Brooklyn patient recovered after 12 days in the hospital and is now at home. But there have been reports of similar patients in the United States and abroad, and the cases have raised troubling questions for doctors.
 

What should doctors do these days when they see patients with apparent heart attacks? Should they first rule out coronavirus infection — or is that a waste of valuable time for the majority of patients who are actually having heart attacks?
 

Should every coronavirus patient be tested for high blood levels of troponin to see if the virus has attacked the heart?
 

“I don’t know what the right answer is,” said Nir Uriel, a cardiologist at Columbia University and Weill Cornell Medicine in New York.
 

The Brooklyn patient had myocarditis, an inflammation of the heart that has been seen in patients with other viral infections, such as MERS — also caused by a coronavirus — and the H1N1 swine flu.
 

But the new coronavirus, called SARS-CoV-2, mostly infects the lungs, causing pneumonia in severe cases. Believing it caused respiratory disease, many cardiologists thought the coronavirus was outside their specialty.
 

“We were thinking lungs, lungs, lungs — with us in a supportive role,” said John Rumsfeld, chief science and quality officer at the American College of Cardiology. “Then all of a sudden we began to hear about potential direct impact on the heart.”
 

A report on heart problems among coronavirus patients in Wuhan, China, was published in JAMA Cardiology on Friday.

The study, led by Zhibing Lu at Zhongnan Hospital of Wuhan University, found that 20 percent of patients hospitalised with Covid-19, the illness caused by the coronavirus, had some evidence of heart damage.
 

Many were not known to have underlying heart disease. But they often had abnormal electrocardiograms, like the patient in Brooklyn, in addition to elevated troponin levels, which sometimes soared to levels seen in patients with heart attacks.
 

The risk of death was more than four times higher among these patients, compared with patients without heart complications.

The journal also published a report, by doctors in Italy, describing a previously healthy 53-year-old woman who developed myocarditis.
 

© 2020 The New York Times News Service