Did you know that some of the symptoms of the common respiratory illnesses that typically spread during the winter months mimic the symptoms of cardiovascular disease?
For example, if you are feeling short of breath or having chest pain, you may think it’s the flu. But it may be something else, especially if you have heart disease or are at risk for it.
That’s why the experts at Mount Sinai Fuster Heart Hospital are warning about the risk of heart problems during the time that respiratory illnesses typically surge, which also coincides with American Heart Month in February.
With a recent surge in influenza, COVID-19, norovirus, respiratory syncytial virus (RSV), and other respiratory viruses, it’s critical to pay close attention to your heart and symptoms—especially if you have heart disease or the risk factors for it, according to the experts. The combination of these four viruses has been termed a “quad-demic” as they are circulating at elevated levels this winter, according to the Centers for Disease Control and Prevention.
Symptoms of respiratory illness can mimic those of cardiovascular disease or cardiac events in high-risk groups. Some patients may think that symptoms such as being short of breath, weak, cold, or feverish, or having dizziness or chest pain may be solely a result of these winter viruses, but these symptoms could also be associated with, and masking, dangerous cardiovascular complications such as heart attack, pulmonary embolism, viral myocarditis, pericarditis, or even heart failure.
“We have seen people mistaking virus symptoms for serious heart complications. For example, some patients have shortness of breath, wheezing, coughing, swelling, and palpitations, and assume their symptoms are linked to a cold, when in fact they were actually in heart failure. Other patients who have had persistent chest pain and palpitations after acute viral illness may need to consider that, in fact, this could be myocarditis,” says Johanna Contreras, MD, a cardiologist at Mount Sinai Fuster Heart Hospital.
“Don’t ignore these symptoms thinking they are just a long-lasting viral infection, especially if you’re at high risk of heart disease, as this disease can be treated promptly and avoid long-term complications,” says Dr. Contreras. “Make sure to consult your doctor or call 911 if you have worsening chest pain, dizziness, or shortness of breath—a serious cardiac condition can progress quickly and it’s key to catch complications early, before they become life-threatening.”
The recent surge in viruses can also trigger cardiovascular complications among those with established heart conditions, including fever, dehydration, and increased inflammation, and Mount Sinai cardiologists are seeing a rise in these cases across all age groups.
Patients with underlying cardiovascular disease and the associated risk factors are at increased risk. Inflammation can trigger heart attacks in people with coronary artery disease. It can also exacerbate heart failure symptoms and irregular or rapid heartbeats, leading to hospitalization. Doctors have also seen post-viral myocarditis—inflammation around the heart that can progress to complications such as heart failure and cardiogenic shock—in otherwise healthy patients.
“In fact, anyone is susceptible, even health care providers themselves are susceptible, and anyone who is not paying attention to their symptoms may get sick with potentially life threatening complications,” says Icilma Fergus, MD, Director of Cardiovascular Disparities for the Mount Sinai Health System. “A recent patient had severe shortness of breath, weakness, palpitations and fatigue, fearing they had heart failure. After they had bloodwork taken, there was a frantic moment when we could not reach the patient to share results that revealed a significantly elevated troponin level which can be linked to a heart attack. Although we suspected the worst, we eventually reached the patient and they were hospitalized with Influenza A and severe viral myocarditis. They were treated appropriately and luckily there was a good outcome.”
“If you get sick and have chest pain or are out of breath, or have swelling of the legs, and it’s getting worse—especially if you have an underlying heart condition or risk factors such as obesity, diabetes, or a family history of heart disease—your symptoms of a viral infection may in fact represent cardiac symptoms,” says Anuradha Lala, MD, a cardiologist at Mount Sinai Fuster Heart Hospital. “While the immune system’s primary job is to eliminate the virus, the inflammatory response can inadvertently harm cardiac tissue. Thus, if you have a known heart condition, viral infections can bring on exacerbations—or a worsening of the underlying issue—whether it is atrial fibrillation, coronary heart disease, or heart failure.”
Heart Disease Statistics
Heart disease is the leading cause of death among men and women in the United States. Nearly half of adults—more than 121 million people—have some type of cardiovascular disease. According to the Centers for Disease Control and Prevention, more than 700,000 people die of heart disease annually, and 80 percent of these cases are preventable.
High-Risk Groups
Anyone can get heart disease, but people are more susceptible if they have cardiovascular risk factors such as high cholesterol, high blood pressure, diabetes, being overweight, or using tobacco. Age is also a factor, specifically for menopausal women (between 45 and 55) and men older than 55, and men with a family history also are at higher risk. Getting less than six hours of sleep a night may also contribute to poor outcomes.
Certain groups, including African American and Hispanic/Latino people as well as new immigrants, may also be at higher risk of complications from untreated viral illnesses. However, risk for cardiovascular disease in any population can be decreased by taking simple steps toward a healthier lifestyle.
Tips for Lowering Risk of Heart Disease
- 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 for women and men
- Quit using tobacco or other inhaled substances, including both smoking and electronic cigarettes/vapes
- Watch your weight and exercise regularly
- Learn the warning signs of heart attack and stroke, including chest discomfort; shortness of breath; pain in the arms, back, neck, or jaw; breaking out in a cold sweat; and lightheadedness
- Find practical ways to eliminate stress and focus on mental health
