More than half of heart scans among hospitalised COVID-19 patients are abnormal, suggesting the coronavirus may have a devastating impact on this vital organ, according to new research.
A study from 69 countries, funded by the British Heart Foundation (BHF), found that 55 per cent of 1,261 patients studied had abnormal changes to the way their heart was pumping, with around one in seven showing evidence of severe dysfunction.
The majority (901 patients) had never been diagnosed with heart problems before, leading scientists to conclude that COVID-19 itself may seriously affect the heart.
Among this group, heart scans were abnormal in 46 per cent of patients and 13 per cent had severe disease.
Just over half (54 per cent) of all the scans were performed in intensive care, with others carried out on general wards, heart and lung wards and in A&E.
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Dr Sonya Babu-Narayan, associate medical director at the British Heart Foundation and a consultant cardiologist, said: “Severe COVID-19 illness can result in damage to the heart and circulatory system.
“We urgently need to understand more about why this is happening so we can provide appropriate care – both short and long term.
“This global study – carried out at the height of the pandemic – shows that we must be on the lookout for heart complications in people with COVID-19 so that we can adapt their treatment if needed.”
The study, published in the European Heart Journal – Cardiovascular Imaging, found the abnormalities were almost evenly split between the left and right chambers of the heart.
Some 3 per cent of patients had suffered a recent heart attack, according to the scans.
As a result of their scan, one third of patients had their treatment changed, including being given medicines for heart failure, or more careful control of fluids and therapy designed to support heart function.
The study was carried out by researchers from the British Heart Foundation Centre of Research Excellence at the University of Edinburgh.
The team cautioned that the study cannot conclude how common heart changes are in people who did not receive scans.
They stressed that all patients in the study were in hospital and had suspected heart complications.
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Professor Marc Dweck, who led the research, said: “COVID-19 is a complex, multi-system disease which can have profound effects on many parts of the body, including the heart.
“Many doctors have been hesitant to order echocardiograms for patients with COVID-19 because it’s an added procedure which involves close contact with patients.
“Our work shows that these scans are important – they improved the treatment for a third of patients who received them.
“Damage to the heart is known to occur in severe flu, but we were surprised to see so many patients with damage to their heart with COVID-19 and so many patients with severe dysfunction.
“We now need to understand the exact mechanism of this damage, whether it is reversible and what the long-term consequences of COVID-19 infection are on the heart.”
Reader Q&A: Why is the heart slightly to the left in the chest?
Asked by: Adam King, Huddersfield
The heart is located fairly centrally beneath the breastbone, but it does protrude towards the left. This is because the heart’s bottom-left chamber (the ‘left ventricle’) is responsible for pumping oxygenated blood around the whole body, so it needs to be stronger and larger than the right ventricle, which only pumps blood to the lungs.
It’s this left ventricle that you can feel beating in your chest. One in 10,000 people actually have a mirror-image heart which points towards the right – a condition known as ‘dextrocardia’.