Cardiomyopathy—one of the major causes of heart failure—is both a major risk factor and a serious complication of COVID-19.
Cardiomyopathy and COVID-19 Risk
Cardiomyopathy refers to any disease of the heart muscle that makes it harder for the heart to pump blood. As cardiomyopathy worsens, it’s less able to maintain a normal electrical rhythm, resulting in heart failure and arrhythmia.
One of the reasons that people with cardiomyopathy become severely ill with COVID-19 is that the disease causes a flood of inflammatory cells called cytokines to be released from the immune system into the blood. These cells can thicken blood, making it harder for the heart to move blood throughout the body and increasing a person’s chance of developing a blood clot.
This is even more of a problem when your heart has already been weakened by diseases like cardiomyopathy before you develop COVID-19. If you become severely ill with COVID-19, cardiomyopathy and other cardiac complications of the disease can lead to cardiogenic shock and multiple-organ failure, increasing the risk of death.
Complications of Cardiomyopathy and COVID-19
In addition to being more susceptible to severe illness, people with heart problems like cardiomyopathy are also at risk of developing chronic complications even after the illness resolves. This is due to the body—especially the heart—becoming weaker by COVID-19.
Many tissues have the ability to rehabilitate themselves after illness, but heart tissue does not. Once your heart muscle is damaged, its ability to function is permanently lowered. The goal then becomes to prevent further tissue loss or damage as the heart works to compensate for its weakness and avoid complications from losing blood flow to other organs.
Even a mild case of COVID-19 can lead to long-term, sometimes permanent, heart damage. Viral infections like COVID-19 can worsen pre-existing cardiomyopathy. Some researchers have even suggested that cardiomyopathy and heart failure may be the natural result of COVID-19 rather than a rare complication.
Cardiomyopathy Caused by COVID-19 Stress
Evidence suggests that emotional or physical stress can cause a rare form of cardiomyopathy called takotsubo cardiomyopathy, or stress-induced cardiomyopathy. Sometimes referred to as broken heart syndrome, it causes weakness on the left side of the heart, which pumps blood out to the body.
Before the pandemic, about 1% to 2% of acute coronary syndrome cases were attributed to stress-induced cardiomyopathy. During the pandemic, this number rose to about 8%. Some of these cases were traced to the havoc that the virus wreaks inside the body, but a large number developed in people who had tested negative for COVID-19.
Certain groups of people are at higher risk of experiencing stress-induced cardiomyopathy, including postmenopausal women and people with existing mental health challenges.
Treatments for Cardiomyopathy and COVID-19
Treatment for cardiomyopathy primarily focuses on improving the heart’s ability to pump blood to areas of the body that are damaged, preventing complications like fluid buildup and treating other adverse effects of poor heart function.
Some medications frequently prescribed for cardiomyopathy include:
Beta blockers Angiotensin-converting enzyme (ACE) inhibitors Angiotensin II receptor blockers Diuretics Digoxin
Because these medications will not increase a person’s risk of contracting COVID-19 or of experiencing severe symptoms if they do become sick, they are safe to take. Do not stop or change the dosage of your heart medications without consulting your healthcare provider first.
Implantable pacemakers or defibrillators also may be recommended to help the heart function better. However, these forms of treatment are invasive, and these devices, which can be monitored virtually through telehealth, can pose complications in people with cardiomyopathy and heart failure.
If you have a pacemaker or defibrillator, you most likely already take a medication that helps prevent blood clots from collecting around the device. Since the risk of blood clots increases during a coronavirus infection, be sure to continue taking the anticoagulant medications your healthcare provider has prescribed.
How to Stay Safe
There are a number of measures you can take to reduce your chances of contracting COVID-19:
Social distancingWearing a maskPracticing good hand hygieneBecoming vaccinated when you can
Additionally, people with high-risk conditions like cardiomyopathy may want to take some extra precautions, such as to:
Stock up on at least 30 days of your regular medicationsConsider setting up deliveries for food and medicationsMake sure you have medical supplies like oxygen tanks and tubing if you need themMake sure you are up-to-date on all vaccinationsDiscuss a plan with your healthcare provider to safely continue with regular care for your conditionConsider using telehealth with your healthcare provider to reduce exposureConsider rescheduling nonessential appointments or proceduresStay healthy with a good diet and regular exercise
A Word From Verywell
Not only is cardiomyopathy a risk factor for a more severe case of COVID-19, it can also be a complication of the disease. Because of that, people with cardiomyopathy should take precautions to avoid contracting the novel coronavirus and talk to their healthcare provider about how to manage their condition if they do end up getting COVID-19. If you suffer from long-term COVID-19 complications, such as ongoing shortness of breath or chest pain, be sure to follow up with your healthcare provider.
The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.
In severe COVID-19 infections, sepsis and cardiogenic shock are common complications. There also has been evidence that some people who become severely ill with COVID-19 go on to develop Takotsubo syndrome, or stress cardiomyopathy. How this form of nonischemic cardiomyopathy develops in people with COVID-19 isn’t quite clear, but there is a link to sepsis and increased death rates in hospitalized COVID-19 patients.
