When you hear “cardiovascular disease,” what comes to mind first? Many people immediately think of heart attack—which is certainly a very important condition to consider. Yet, there are a number of maladies that fall under the cardiovascular disease umbrella.
Dr. David Jones, board-certified cardiologist with Palouse Heart Center, part of the Pullman Regional Hospital Clinic Network, describes cardiovascular diseases as a “broad spectrum of ailments” that affect the heart or vascular system.
For example, one category is arrhythmias, such as atrial fibrillation, atrial flutter, supraventricular tachycardias, premature ventricular beats, and premature atrial beats. Atherosclerotic diseases can lead to angina, heart attacks, and bypass surgery. Diseases of the heart muscle itself include cardiomyopathy, which often leads to congestive heart failure, or valvular heart disease, which can also lead to heart failure by obstructing blood flow.
Atrial fibrillation, or AFib, is a sustained, irregular heartbeat; often rapid. If a patient has the right combination of risk factors, AFib can ultimately lead to both heart attack and stroke.
There are many other causes of irregular heartbeats that are not considered atrial fibrillation, but AFib is still quite common. “I think it's probably more in the public eye with devices such as the Apple watch, which monitors and detects atrial fibrillation,” states Dr. Jones.
What’s important for patients to know is that AFib can be managed with cardioversion and antiarrhythmic medications. Risks of stroke and heart failure can also be mitigated with blood thinners and medications designed to slow heart rates.
The most common symptom of AFib is actually feeling the rapid irregular heartbeat. Other symptoms include a sensation of the heart “shifting” in the chest, palpitations, discomfort, fullness in the neck area, shortness of breath, and a need to cough.
However, a large number of patients surprisingly have no symptoms. “As many as close to half of people who have atrial fibrillation don't even know it's occurring,” cautions Dr. Jones. “It's often caught in the doctor's office. For people with atrial fibrillation who don't feel it, and don't know they have it, the risk of problems in that subset is a little less certain.”
COVID-19’s impact on cardiac health remains to be an evolving set of knowledge. For the most part, people who are asymptomatic, or have mild-to-moderate COVID-19, won’t develop heart problems.
“There is a small subset of patients who may be asymptomatic or mild or moderately symptomatic, who might have symptoms like shortness of breath, racing heartbeats, even chest pain. Whether those are truly coming from the heart is not entirely clear at this point,” explains Dr. Jones.
The most alarming effect cardiologists have seen is that some individuals, particularly patients who are athletes, will develop inflammation of the heart (myocarditis). This can lead to a weak heart or even heart failure. Symptoms include shortness of breath, chest discomfort, and faster than expected heart rates with light activity, standing up, or even sitting in place.
Taking preventive measures is one way individuals can be active participants in their own heart health. Dr. Jones recommends a heart-healthy diet and routine aerobic exercise.
“Walking 40 minutes four times a week exceeds the national recommendation from the American Heart Association for routine aerobic exercise, which is 150 minutes. For a heart-healthy diet, choose a selection of fresh vegetables and fruits and avoid foods that are high in cholesterol and fat.”
He also urges individuals to regularly engage with your physician and schedule necessary appointments to stay on top of your health. “That might look like once a year, it might be once every two years, or it might also be more frequent, depending on symptoms or problems needing to be managed.”