In the beginning of 2020, Lisette Virella was in the best shape of her life. The collegiate soccer player was training hard when the season was cancelled and her classes went remote.

Back home in Sicklerville, the entire household – Virella, her parents and sister – contracted Covid-19 at the same time. Virella’s parents got really sick and required hospitalization, but her case was more mild – or so she thought.

A few months after her Covid-19 diagnosis, Lisette Virella, 22, discovered she had a heart condition

About a month after her recovery, Virella was back to working out when she noticed something was way off. Any time she’d start running, her chest would tighten within minutes to the point that she’d lose vision and almost pass out.

“It was like I never played a sport before,” says Virella, 22. “My heart was beating too fast for how much blood I was producing. It was extremely painful.”

This wasn’t a lung issue, which is most often associated with Covid-19. Virella was diagnosed with a heart condition called viral cardiomyopathy. It’s not known if her issues were caused by Covid-19 or if the virus triggered an undiagnosed pre-existing condition. Either way, it’s becoming clear that Covid affects our hearts more than doctors first thought.

“The lungs get the most attention because it’s the first diseased organ we were aware of, but this is a virus that affects the entire body,” says M. Scott Dawson, MD, an Inspira cardiologist and a member of Cardiac Partners.

How the virus disrupts heart function

Common Covid symptoms like severe fatigue and shortness of breath are telltale signs of respiratory issues, but they can also be caused by, or exacerbated by, weakness in the heart muscle, says Dawson. And when Covid and heart disease mix, it can cause devastating damage.

“Covid initially comes in as a respiratory disease, but as it progresses into further stages, it can become a disorder that causes blood clots, inflammation and other disruptions,” says Dawson.

The stress of your immune system trying to fight the virus can make it harder for the heart to pump blood to the rest of your body. It can also affect your blood vessels’ ability to feed the heart muscles, and it could lead to inflammation in your arteries. All of these issues, says Dawson, can trigger a heart attack or heart failure.

“Patients also have a much higher risk of developing blood clots as they enter the second week of treatment,” says Dawson. “When they develop a Covid infection, it can lead to the development of spontaneous blood clots, whether it is in their arms, legs, brain or even their heart.”

How Covid strains heart functioning

All of these complications force the heart to work even harder to keep the rest of the body going, says Troy Randle, DO, a Virtua Health cardiologist.

“When Covid-19 broke out, it was especially dangerous for cardiac patients because there really is no such thing as a ‘nonessential’ cardiology issue,” says Randle. “Because the heart is over-stressed, we’ve noticed increases in irregular heart rhythms as well as a condition called tachycardia, which causes the heart to beat unnaturally fast.”

As the virus attacks the lungs, the heart must work overtime to make up for low oxygen levels. This higher demand on the heart, he says, can also lead to heart failure or heart attacks, even in young patients.

“I’ve had patients in their 20s who experience significant strain in their hearts after a Covid infection,” says Randle. “While we hope their heart function will go back to normal, only time will tell, and it’s too soon.”

How Covid creates a greater danger for heart patients

Anyone sick with Covid could develop a heart condition, says Daniel Tarditi, DO, a cardiologist with Jefferson Health – NJ, not just those with pre-existing issues. But for patients already battling heart disease, the virus can create an even more imposing risk.

“Patients with heart failure run 3 times the risk of being intubated if they have Covid,” says Tarditi. “That puts them at twice the risk of dying from the virus, and for those who do recover, it typically leads to hospital stays 2 to 3 days longer than patients without heart failure.”

Another big issue for cardiac patients is fear itself, he says.

“People who may be experiencing symptoms of cardiac disease may refrain from coming into the hospital because they’re afraid of contracting the virus,” says Tarditi. “Patients have been pushing off their symptoms, so they’re coming in sicker than ever.”

Patients avoiding the hospital is nothing new, he says, but particularly now in a public health crisis, it’s better to take every precaution.

“What patients don’t realize,” says Tarditi, “is that heart disease doesn’t necessarily mean a long stint in the hospital. There are outpatient treatment options, medications and even telehealth visits that make it possible for doctors to treat many patients’ cardiac disease with minimal in-office visits.”

How cardiac patients can protect themselves

For patients battling heart disease, it’s especially important to be extra cautious during the pandemic until they can be vaccinated, says Phillip Koren, MD, a cardiologist with Cooper University Health Care.

“Cardiac patients run a higher risk of contracting serious cases of Covid-19,” he says. “So it’s best to equip yourself against the disease with every protection possible.”

Koren, who treats some of the sickest Covid-19 patients in the state, says the virus can cause devastating long-term damage to the heart. He’s seen the worst of it, and the only way out, he says, is through a vaccine.

“The fear of the illness should far outweigh the fear of the vaccine,” he adds. “I’ve seen this virus destroy communities, take aunts, uncles, parents, kids from their families. The quicker we hit herd immunity, the quicker we can get our lives back.”