Heart Disease and COVID-19: How to Reduce Your Risks

During the pandemic, you may be exercising less, limiting your trips outside, and no longer eating a healthy diet, and this may be taking its toll. Some doctors say 25 percent of their patients have gained up to 20 pounds, and that can be leading to decline in mental health.
As a result, during this difficult period, experts at Mount Sinai are encouraging a focus on exercise, mental health, and nutrition, especially for those already at risk for heart disease, and they are sharing some tips on heart disease prevention to lower the risk of heart attack, stroke, and COVID-19.

Icilma Fergus, MD
“It is critical to stay physically fit and in your best personal health to combat heart disease, COVID-19 infection and the post-COVID effects,” says Icilma Fergus, MD, Director of Cardiovascular Disparities at The Mount Sinai Hospital. “During this pandemic some patients have expressed they’re dealing with stress, anxiety, insomnia, and depression. We discuss techniques to improve their mental and emotional wellness, which carries over to their cardiovascular health.”
Doctors say participating in home-exercise programs, taking a short walk, dancing, stretching, and even house cleaning will get you moving and make a difference.
“Keeping a good mental outlook is also key and it’s important for people to find ways to ensure that this happens by staying active, meditating, or simply doing things that make them happy,” says Dr. Fergus.
• Know your family history.
• Be aware of five key numbers cited by the American Heart Association: blood pressure, total cholesterol, HDL (or “good”) cholesterol, body mass index, and fasting glucose levels.
• Maintain a healthy diet, eating nutrient-rich food and eliminating sweets. Limit alcohol consumption to no more than one drink per day. Quit smoking. Watch your weight and exercise regularly.
• Learn the warning signs of heart attack and stroke, including chest discomfort; shortness of breath; pain in arms, back, neck, or jaw; breaking out in a cold sweat; and lightheadedness.
According to the American Heart Association, about one in three people with COVID-19 has cardiovascular disease, making it the most common underlying health condition. COVID-19 patients with underlying conditions are six times more likely to be hospitalized and 12 times more likely to die than patients without any chronic health problems.
Nearly half of adults in the United States—more than 121 million people—have some type of cardiovascular disease. It is the leading cause of death among men and women in the United States; nearly 650,000 die from it every year. Yet heart disease is preventable 80 percent of the time.
COVID-19’s Impact on the Heart and Recovery
COVID-19 can cause an inflammatory response in the body, along with clotting that can impact the heart and how it functions. Mount Sinai researchers discovered that some hospitalized COVID-19 patients have structural damage after cardiac injury that can be associated with deadly conditions including heart attack, pulmonary embolism, heart failure, and myocarditis, or inflammation of the heart.
Non-hospitalized COVID-19 patients can also experience complications including heart rhythm disorders, hypertension, myocarditis, and chest pain that feels similar to a heart attack. Cardiologists say it’s important for COVID-19 survivors—even without cardiac symptoms—to have a heart exam two to three weeks after recovery, as there could be residual effects that may go undetected and lead to future health problems.
“For anyone who developed heart issues post-COVID-19, exercise should be delayed two to three weeks after resolution of symptoms including chest pain, palpitations, and shortness of breath. Remember to ‘go slow’ as recovery from this illness is not a sprint; it is a marathon,” says Maryann McLaughlin, MD, Director of Cardiovascular Health and Wellness at Mount Sinai Heart. “Anyone who has been diagnosed with myocarditis needs to be under a physician’s direction when deciding to exercise, and competitive athletes may need three months to recover from the illness before returning to full routine.”
Recovered COVID-19 patients with a history of heart attack, coronary artery disease, or cardiac stents, should get a monitored stress test before getting back to a full workout. Anyone who had chest pain while sick with COVID-19 should talk to their doctor about evaluation with an echocardiogram or other cardiac imaging.
High-Risk Groups and COVID-19 Vaccinations
Everyone is at risk of heart disease, but people are more susceptible to getting the disease if they have cardiovascular risk factors including high cholesterol, high blood pressure, being overweight, and using tobacco. Age is also a factor, specifically for women over 65 and men older than 55, along with those with a family history of heart disease and people who sleep less than six hours a night.
Certain minority groups including African Americans and Latinos are also at higher risk due to genetic predisposition, diet, lifestyle factors, and socio-economic factors. However, illness in any population can be prevented by taking simple steps towards a healthier lifestyle.
Mount Sinai cardiologists encourage those in these high-risk groups to get a COVID-19 vaccine when they qualify under state distribution guidelines.
“We have noticed some patients in these high-risk minority groups have been reluctant to get vaccinated, fearing it’s not safe. What is important for them to understand is that tremendous scientific advancements have led to the safe development of COVID-19 vaccines and we are encouraging them to get vaccinated,” says Johanna Contreras, MD, Director of Heart Failure and Transplantation at Mount Sinai Morningside.









“I feel a sense of moral obligation to get vaccinated if it means I’ll be less likely to contribute to further spread of the disease,” said Jamie Piekarski, NP, who provides emergency psychiatric care to patients when they first enter Mount Sinai Beth Israel. Like many others, she decided to receive the vaccine in order to keep herself, her patients, and her family safe. She felt lucky to be among the first employees offered the vaccine. “This is our quickest way back to something close to normal.”
“Getting the vaccine is very emotional for me,” said Matthew Bai, MD, an emergency medicine doctor at Mount Sinai Queens, and an Assistant Professor of Emergency Medicine at the Icahn School of Medicine at Mount Sinai. “We have all been dealing with the pandemic for what seems like an eternity, and every day going to work, COVID-19 is always in the back of your mind. This is a symbol, an actual step toward going back to a normal life.”
Deborah Dean, MD, FACEP, Director of Emergency Medicine, was the first Mount Sinai Brooklyn employee to receive the vaccine, and she was joined by ED Nursing Director Bobby Lynch and ED Administrative Director Sue Stefko, who also received the vaccine.
Ugo A. Ezenkwele, MD, chief of the Mount Sinai Queens Emergency Department and an Associate Professor of Emergency Medicine at the Icahn School of Medicine, said he and all of the staff were excited about the vaccine becoming available. He received the vaccine in order to help protect his colleagues and his family.
Amanda Bates, MD, an emergency medicine doctor at Mount Sinai Queens, was looking forward to receiving the vaccine as soon as it was offered. “I have been working in emergency rooms since the pandemic started, and it has been incredibly devastating for patients and their families. I have seen a lot of complications that come from COVID-19 and it’s not something I want for myself, my family, or my patients,” she said. “I trust the vaccine. It is new, but the science behind it isn’t new. I feel confident that any risks that come with a new vaccine are far less severe than the risks that come with getting COVID-19. I think it’s the right thing to do to protect yourself and your community.”
Jonathan Nover, RN, MBA, Senior Director of Nursing in the Mount Sinai Queens Emergency Department, added: “I want to set an example for my team and my family, and I want to put all this behind us. Vaccines are safe, they are proven, and we need to move our lives forward. I feel very lucky and blessed for this opportunity, and I feel happy to let my staff, my family, and my friends know I was able to get the vaccine. I feel really proud of that.”
Mateow Espinosa, a Care Team Assistant and Scribe at Mount Sinai Beth Israel, said: “A lot of people around me are hesitant to get the vaccine. I feel like it is necessary for me to take the vaccine as a way to educate the people around me. It is also important for me to keep myself and family safe.”
Luis Coello, a security officer at Mount Sinai Beth Israel: “I decided to take the vaccine because I do not want to get COVID-19, and I want to keep my family safe.”
Young Lee, MD, ICU Medical Director at Mount Sinai Beth Israel and an Assistant Professor of Medicine (Pulmonary, Critical Care and Sleep Medicine) at the Icahn School of Medicine: “It was much less painful than the flu vaccine. I decided to take this vaccine to protect myself, as well as my patients and my family.”
Farah Ali, a physician assistant in an emergency department at Mount Sinai Beth Israel: “What a whirlwind, brilliant year for medical science. It is surreal, a little scary, but overall exciting to be among the very first to get this vaccine. I got the vaccine for my Gramma and Grampa.”
Crystal Toribo, PharmD, a pharmacy resident at Mount Sinai Beth Israel: “The side effects of this vaccine are very similar to the flu shot. For anyone who is hesitant to take it, please know that there are so many people here in the hospital to speak to about it, so always feel free to ask questions about side effects and safety. To me, it is important that I get vaccinated so I can protect others, myself, and my family members.”