Many individuals experience persistent symptoms after a COVID-19 infection, with heart palpitations being a notable concern. This article explores the connection between COVID-19 and heart palpitations, discussing their causes and when to seek medical attention.
Understanding Heart Palpitations
Heart palpitations are sensations of an irregular, fast, or hard heartbeat. They can feel like a fluttering, pounding, racing, or skipped beat in your chest, throat, or neck. While often harmless, they can be unsettling. Palpitations can occur due to various factors.
How COVID Can Trigger Palpitations
COVID-19 can trigger heart palpitations through several mechanisms. One involves inflammation, as the virus can cause systemic inflammation. This includes myocarditis (heart muscle inflammation) or pericarditis (inflammation of the sac around the heart). These inflammatory responses can alter the heart’s electrical signals, potentially leading to irregular rhythms or a faster heart rate.
Another mechanism involves the autonomic nervous system (ANS), which regulates heart rate and blood pressure. COVID-19 or the body’s immune response can disrupt the ANS, leading to conditions like Postural Orthostatic Tachycardia Syndrome (POTS). POTS often causes a significant increase in heart rate upon standing. Direct viral effects on heart cells are also a possibility, as the SARS-CoV-2 virus can invade and replicate within heart muscle cells, potentially causing cell damage and interfering with their ability to contract.
Beyond direct physiological impacts, stress and anxiety from illness can activate the body’s “fight or flight” response, increasing heart rate and leading to palpitations. Dehydration and electrolyte imbalances, which can occur during or after a COVID-19 infection, may also contribute. Imbalances in electrolytes such as potassium, sodium, and magnesium can disrupt the electrical signals necessary for a stable heart rhythm.
When to Seek Medical Care
While heart palpitations can often be benign, certain symptoms warrant immediate medical attention.
- If palpitations occur alongside chest pain or pressure, seek urgent care.
- Shortness of breath, especially if sudden or severe, also requires prompt evaluation.
- Dizziness, lightheadedness, or fainting spells in conjunction with palpitations require medical assessment.
- If your heart palpitations are frequent, prolonged, worsening over time, or if you have a pre-existing heart condition, consult a healthcare professional. These symptoms may indicate a more serious underlying issue.
Diagnosis and Management Approaches
To diagnose the cause of heart palpitations after COVID-19, a healthcare provider will typically begin with a thorough review of your medical history and a physical examination. They may order several diagnostic tests to assess your heart’s function and rhythm. An electrocardiogram (ECG or EKG) is a common initial test that records the electrical signals of your heart, helping to identify if the heart is beating too fast, too slow, or irregularly.
For intermittent palpitations that do not occur during a standard ECG, a Holter monitor may be used. This portable device is worn for 24 hours or longer to continuously record the heart’s electrical activity during daily activities. An event recorder, another type of portable monitor, can be worn for several weeks and activated by the patient when symptoms occur. Blood tests may also be conducted to check for underlying conditions that can contribute to palpitations, such as electrolyte imbalances (e.g., potassium, magnesium) or thyroid dysfunction. In some instances, an echocardiogram, which uses sound waves to create images of the heart, might be performed to evaluate the heart’s structure and pumping function.
Management approaches for post-COVID heart palpitations are tailored to the identified cause. If no serious underlying heart condition is found, lifestyle adjustments are often recommended.
These can include ensuring adequate hydration, reducing or avoiding caffeine and alcohol intake, and implementing stress management techniques. Getting sufficient rest and gradually increasing physical activity can also help improve heart rate regulation and overall well-being.
In cases where specific issues like autonomic nervous system dysfunction or electrolyte imbalances are identified, targeted interventions may be suggested. For some individuals, a healthcare provider might consider prescribing medication to help regulate heart rate or rhythm.