Diagnosing Viral Heart Infections
When it comes to diagnosing heart infection, EKG is the first tool your doctor uses. An EKG measures the electrical signals inside your heart. Its these signals that keep your heart beating in a normal rhythm, opening and closing the valves and contracting the heart muscle to keep blood flowing. Both pericarditis and myocarditis can cause abnormalities in your heart rhythm, so its a good, noninvasive way to test for symptoms of the infection.
The doctor also may order a chest X-ray to see the size and shape of your heart, or an echocardiogram, a kind of ultrasound scan that lets the doctor see the heart structures and watch how blood flows through your heart. Sometimes, a tissue biopsy is necessary to confirm a diagnosis and determine what type of virus is infecting the heart. Blood tests can also be used to look for elevated white blood cells counts or other signs of infection.
Cdc Study Finds Sudden Serious Cardiac Events Common In Adults Hospitalized With Flu
A CDC study published today that looked at more than 80,000 U.S. adults hospitalized with flu over eight flu seasons found that sudden, serious heart complications were common and occurred in one out of every eight patients .
The study looked at a range of sudden heart complications called acute cardiac events that resulted in the following:
- damage to the heart muscle,
- inflammation of the heart muscle,
- fluid or inflammation of the sac surrounding the heart, or
- weakening of the pumping function of the heart.
The most common acute cardiac events reported in the study were acute heart failure and acute ischemic heart disease. Acute heart failure is the sudden inability of the heart to pump enough blood to meet the bodys demands, while acute ischemic heart disease is a term that describes heart problems caused by narrowed or blocked heart arteries.
Previous studies have looked at the relationship between influenza infection and heart attacks or heart failure, but few large, population-based studies have examined the frequency of acute cardiac events associated with laboratory confirmed influenza infection. Therefore, this study contributes new and important findings to the scientific body of evidence on this topic.
The study is subject to several limitations. There was likely under-detection of influenza cases, as flu testing was based on practitioner orders. Also, acute cardiac events were identified by ICD discharge codes and may be subject to misclassification bias.
Vaccination Is The Best Protection Against Flu
Flu vaccination is especially important for people with heart disease or who have had a stroke because they are at higher risk for complications from flu. Vaccination has been associated with lower rates of some cardiac eventsexternal icon among people with heart disease, especially among those who had had a cardiac event in the past year.
Flu vaccines are updated each season to keep up with changing viruses. Because the immunity provided by flu vaccines decreases over time, annual vaccination is needed to ensure the best possible protection against flu. A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season. More information about why flu vaccines may be updated each year is available: Vaccine Virus Selection, as well as this seasons exact vaccine composition.
CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year, ideally by the end of October.
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Effects Of Viral Influenza On The Cardiovascular System
The reason influenza stresses the heart and vascular system so much has to do with the body’s inflammatory response to the infection.
Inflammation occurs when your body’s “first responders” white blood cells and what they produce in order to protect you convene in an area and get to work fighting an infection, bacteria or virus. When you’re sick, you can typically feel the effects of these “combat zones” in the swelling, tenderness, pain, weakness and sometimes redness and increased temperature of your joints, muscles and lymph nodes.
The increased activity can also cause a traffic jam of sorts, leading to blood clots, elevated blood pressure and even swelling or scarring within the heart. The added stressors make plaque within your arteries more vulnerable to rupture, causing a blockage that cuts off oxygen to the heart or brain and results in heart attacks or strokes, respectively.
Additionally, non-cardiac complications from the viral illness, including pneumonia and respiratory failure, can make heart failure symptoms or heart arrhythmia much worse.
In short, the added stress on the cardiovascular system could be overwhelming to an already weakened heart muscle.
How The Flu Can Affect Your Heart
If you get the flu, your immune system moves aggressively to fight off the virus. The response leads to internal inflammation, which can elevate your blood pressure and put extra stress on your heart.
Plaque buildup in arteries becomes increasingly vulnerable to ruptures in this situation. As the plaque weakens and breaks, artery-clogging clots can form and disrupt blood flow to your heart a blockage could trigger a heart attack.
Anyone with an existing heart issue is more likely to have their cardiovascular system overwhelmed by the effects of the flu, says Dr. Englund.
Fighting off the infection can put a lot of stress on the heart, she adds. If you have an underlying health issue, such as heart disease, complications from the flu can cascade into something much worse.
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Infection Inflammation And Atherosclerosis
The role of infectious agents in atherosclerosis has been recognized for more than a century. William Osler 3 was one of the first to propose a major role for acute infection in the pathogenesis of atherosclerosis. In the early 20th century, a few pioneer scientists used several infectious agents to induce atherosclerosis in animal models. By the late 1970s, scientists began to study the role of herpesviruses and Chlamydia pneumoniae and, later, of Helicobacter pylori, Mycoplasma pneumoniae, Porphyromonas gingivalis, enterovirus, and a growing list of other agents in atherogenesis . 411 This effort coincided with the emergence of new evidence pointing to atherosclerosis as an inflammatory disease. 12 The role of infection in endothelial injury and vascular wall inflammation came under scrutiny. 13 Many infectious agents have been investigated in this regard, but none of them has proved to play a causative and specific role. Chlamydia pneumoniae has been studied the most extensively, but the results of large clinical trials of antibiotics against this disease have been largely disappointing. 14,15
TABLE I. Infectious Agents Implicated in Atherosclerosis
The Flu And Pneumonia
Pneumonia can be caused by more than 25 germs. Pneumonia in the elderly is caused by bacteria or a virus. The elderly are more susceptible to pneumonia because they have a decreased immune system. Pneumonia along with the flu was the 8th leading cause of death according to the Centers for Disease Control. Regular colds do not cause congestive heart failure.
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Who Is At Risk Of Myocarditis Caused By Flu
There is no way to say that anyone is absolutely safe, but people who already suffer from heart-related conditions are at higher risk. Some scientists claim that endothelial dysfunction is often responsible for the development of flu-related myocarditis. This inner layer can be damaged by issues with the heart valves, arrhythmias, turbulent blood flow because of high blood pressure, ischemic heart disease, or other heart problems.
Can The Flu Cause Other Serious Health Issues
Absolutely and thats a reality seen through statistics from the Centers for Disease Control and Prevention .
Between 2010 and 2020, the flu hospitalized between 140,000 and 710,000 in the U.S. annually, according to estimates from the CDC. Deaths tied to the flu ranged from 12,000 to 52,000 over the same period.
People often underestimate the flu, notes Dr. Englund. Its not just a cold, and it can be deadly.
Possible complications from the flu include:
- Pneumonia and bacterial pneumonia, which can lead to respiratory failure. This is the #1 complication, says Dr. Englund. If peoples pneumonia gets bad enough, theyll often end up on a ventilator.
- Additional cardiac issues such as myocarditis or an arrhythmia.
- Stroke, through the same clotting process that can cause a heart attack.
- Encephalopathy .
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Choose A Safe Medication
When youâre shopping for an over-the-counter medication, check the label. Look for a product thatâs decongestant-free or made just for people with high blood pressure. can raise your blood pressure and interfere with other medications.
Talk to your doctor or pharmacist before you try any OTC treatment. Make sure you tell each of your doctors about all of the medicines you’re taking — prescription and over the counter.
The Flu And Congestive Heart Failure
For people who are diagnosed with congestive heart failure, the flu can be very challenging. This is Therefore because the flu affects the lungs. The flu causes inflammation in the body. Inflammation is a known trigger of heart disease.
People with congestive failure have problems with fluid, especially around the heart. Therefore, it is essential that the lungs are not compromised in a patient with congestive heart failure.
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Other Preventive Actions For People With Heart Disease Or History Of Stroke
Like everyone else, in addition to getting a flu shot, people with heart disease or who have had a stroke should take everyday preventive actions, including avoiding people who are sick, covering coughs, and washing hands often.
Specific Health Actions for People with Heart Disease or History of Stroke
- Plan ahead to maintain sufficient supplies of your regular medications for chronic medical conditions .
- Do not stop taking your regular medications without first consulting your health care provider, especially in the event that you become sick with flu or another respiratory infection.
- People with heart failure should be alert to changes in their breathing and should promptly report changes to their health care provider.
Study Confirms Link Between Influenza Heart Complications
The findings, published in the Annals of Internal Medicine, underscore need to get a flu shot early, the lead researcher says.
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The link between influenza and serious heart conditions just grew stronger.
A CDC study looking at more than 80,000 adult patients hospitalized with flu over eight seasons found that sudden, serious heart complications were common, occurring in 12% of patients, or 1 in 8.
Previous to our study, there had been suggestions between the link, but our study shows just how common it is, said lead author Eric Chow, an infectious diseases fellow at University of Washington School of Medicine.
The study, published Aug. 25 in the Annals of Internal Medicine, underscores the importance of getting a flu shot early.
There are few respiratory viruses we have a vaccine for, he said. Our team motto is ‘Get a flu shot.’ Chow previously worked as an epidemic intelligence service officer, or disease detective, for influenza at the Centers for Disease Control and Prevention.
The study found that 5% of patients hospitalized with the flu had a cardiac complication despite having no documented underlying conditions.
In the past month, there have been cases of otherwise healthy athletes showing signs of heart complications after recovering from COVID-19. For example, 27-year-old Florida State basketball player Michael Ojo, who recovered from COVID-19, died of an apparent heart attack at a practice.
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Recommendations For Cardiovascular Patients
As a result of the demonstrated benefits conferred by influenza vaccination and the risks posed by flu infection among those with cardiovascular disease, the CDC and numerous other international societies strongly recommend annual influenza vaccination in patients with cardiovascular disease.
Clinicians should ensure high rates of influenza vaccination, especially in those with underlying chronic conditions, to protect against acute cardiovascular events associated with influenza.
Unfortunately, many heart patients visit their cardiologist more frequently than their primary care providers, and cardiology practices typically do not provide flu vaccinations, though proposed recommendations may change in the future. Until then, it is incumbent upon both the cardiology provider and the primary care provider to communicate the increased risk to their patients and the importance of getting vaccinated.
For patients with heart conditions, there are two important steps you can take to reduce your risk:
How The Flu Affects People With Heart Disease
The body naturally reacts to an influenza infection with an inflammatory response, meant to defend your body from the virus. But the response can cause blood clots, increased blood pressure and even scarring or swelling in the heart. If you have heart disease, fatty deposits called plaque build up in your arteries. The added stress of a virus can cause the plaque to rupture, resulting in heart attack or stroke.
Non-cardiac complications of flu are also concerning. Common conditions associated with flu, like pneumonia or respiratory failure, can affect an irregular heartbeat or increase heart failure symptoms. Any changes to an already weakened heart make you more prone to a major cardiac event.
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How To Protect Yourself From The Flu
Experts agree that the best thing you can do is to get vaccinated against the flu. “The vaccine is the best way to prevent or minimize cardiovascular complications,” Dr. Adalja says. Dr. Weinberg agrees. While the flu vaccine isn’t perfect, she points out that getting it will dramatically lower your risk of getting seriously ill or developing cardiac complications if you happen to get the virus. In fact, a 2021 study published in Vaccine suggests that flu vaccinations resulted in a 26 percent lower risk of ICU admission rate and 31 percent lower risk of death compared to unvaccinated people. And if you’re not exactly sure where to get jabbed, the CDC has a vaccine locater tool that you can use to get your flu shot .
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Effect On Excess Death
Influenza is a major cause of morbidity and death. Each year, in the United States alone, the flu accounts for 110,000 hospitalizations, 1 to 3 billion dollars in direct costs, and 10 to 15 billion dollars in indirect costs. 37 Although earlier estimates cited 22,000 excess influenza-related deaths each year, 38 newer estimatesderived from epidemiologic datacite 36,000 deaths involving the respiratory and circulatory systems and 51,000 all-cause deaths related to influenza each year in the United States. 39 This increased death is partly due to the aging of the population and to the advent of more virulent viral strains. However, the influenza-related death toll may be even higher: because influenza is not a recognized trigger of MI, it is very unlikely to be recorded on the death certificates of patients who die of MI, stroke, heart failure, or cardiac arrest. Consequently, the number of deaths triggered by influenza is under-recorded. In fact, our estimatesderived from clinical trials and case-control studiesshow that, by triggering cardiovascular events, influenza may cause up to 90,000 deaths per year.
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Long Covid And The Heart
When it comes to long COVIDa constellation of symptoms, including fatigue, shortness of breath, brain fog and anxiety, that persist for several monthsit is still difficult to establish an association with cardiovascular health.
What we dont knowand Im speaking as a cardiologistis how many of those patients with long COVID actually have cardiac involvement, Gersh says. Just because they have palpitations doesnt mean theres structural damage to the heart.
It is definitely plausible that the typical presentation of long COVID, which can include fatigue and shortness of breath, may be intertwined with cardiovascular problems. For example, someone with heart failure may have reduced blood flow to the brain, which may cause brain fog. But at this point, it is difficult to disentangle that relationship, Al-Aly notes.
The problems seen in Al-Alys and Tereshchenkos studiesincluding stroke, heart failure and acute coronary diseaseare not happening only in people with recognizable long COVID. A person might have a mild case of COVID, appear to recover completely and still be at a higher risk for cardiovascular problems months down the road.
Unfortunately, the risk estimate is high, says Tereshchenko, adding that these studies suggest the heart risks from COVID may be on par with those from smoking.
Al-Aly agrees. People think of cholesterol, blood pressure and diabetes as risk factors for heart problems. We need to add COVID-19 to that list, he says.
How Viral Infections Affect Your Heart
Everyone knows viruses can cause respiratory illnesses like the common cold and the flu. But viruses can affect other areas of your body, as well, including your heart. Knowing the symptoms of a heart infection can help you get the care you need quickly, so you can reduce your risks of more serious problems, like heart attack and heart failure.
At Prime Heart and Vascular, we use the most advanced techniques to diagnose and treat viral heart infections in patients in Allen, Frisco, and Plano, Texas. Our cardiology team is skilled in identifying the cause of heart infection, so every treatment plan can be tailored to the unique needs of each patient. Heres how to tell if you might have a heart infection.
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