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Coronavirus Risks to Persons With Cardiovascular Disease

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In California, about one in three adults (more than 8 million people) live with cardiovascular disease which includes heart failure, artery disease, hypertension, strokes and other disorders, according to 2016 state data. Los Angeles cardiologist Ernst von Schwarz, MD, says that the public must be better informed about how these pre-existing conditions can lead to serious complications if a person becomes infected with the novel coronavirus.

The American College of Cardiology (ACC) has issued several bulletins to warn patients about the potential increased risk and to encourage “additional, reasonable precautions.

The coronavirus’ main target is the lungs. However, the heart can also be affected, especially if it is a diseased heart which has to work harder to pump oxygenated blood. This could exacerbate problems for a person suffering from heart failure, in which the heart is already having difficulty pumping efficiently.

“The virus itself might cause a myocarditis, which is a virus-induced inflammation of the heart muscle, leading to cardiomyopathy and heart failure,” says Dr. von Schwarz. “In other cases, the coronavirus might even cause cardiomyopathy without inflammation. Of interest, even healthy relatively young men have developed heart failure within days after the respiratory symptoms occurred, and died, according to our sources in China.”

A person with an underlying heart issue also might have a compromised immune system, especially those who are elderly. In those with chronic medical conditions, the body’s immune response is not as strong a response when exposed to viruses, opening the possibilities of causing complications.

A virus also may pose a special risk for people who have a buildup of plaque in their arteries. Evidence indicates similar viral illnesses can destabilize these plaques, potentially resulting in the blockage of an artery feeding blood to the heart.

New information about the novel coronavirus is developing rapidly. But previous coronaviruses, including SARS and MERS have been linked to problems such as inflammation of the heart muscle, heart attack and rapid-onset heart failure, according to the ACC bulletin.

Ernst von Schwarz, MD, Ph.D., FESC, FACC, FSCAI is board certified in Cardiovascular Diseases and Advanced Heart Failure & Transplant Cardiology by the American Board of Internal Medicine. His primary clinical and research interests are end-stage heart failure, interventional cardiology, stem cell therapy and sexual function in cardiac disease. Dr. von Schwarz practices in Los Angeles and Temecula, CA.

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