COVID-19 Symptom: Heart Palpitations

• A variety of heart issues have been reported in people with COVID-19, including heart palpitations and fast heart rate.
• Inflammation, cell damage, and blood clots are some of the potential causes of COVID heart palpitations.
• Symptoms such as a racing heart, chest discomfort, shortness of breath, lightheadedness, or dizziness can all accompany heart palpitations from COVID-19. 
• Living a heart-healthy lifestyle can protect your heart before and after a COVID-19 diagnosis.

If you are experiencing heart palpitations and/ or a high heart rate due to COVID-19, then you are not alone. While COVID-19 is primarily a respiratory illness, it can also affect the cardiovascular system and cause various symptoms, including heart palpitations and an elevated heart rate. 

While most people with COVID-19 experience mild to moderate symptoms, including fever, cough, and fatigue, some individuals may experience more severe symptoms, including those related to the heart. In this article, we’ll explore the potential causes of heart palpitations and high heart rates from COVID-19, discuss ways to manage and prevent these symptoms, and when to seek medical attention.

Heart palpitations have been reported in patients with COVID-19 since the start of the pandemic. Palpitations are the sensation of an abnormal or irregular heartbeat, such as a fluttering, racing, or skipping sensation. While palpitations can be caused by many different factors, including anxiety, stress, or caffeine, COVID-19 and other infections can also raise a person’s heart rate and cause palpitations.

How common are they COVID heart palpitations? According to one study, nearly 12% of people with mild to moderate cases of COVID-19 report them. The study noted that "cardiovascular symptoms, including palpitations and chest pain, may be present in mild to moderate COVID-19 patients."

These symptoms can develop at the onset of COVID-19 symptoms or after the infection has cleared, signaling that the disease has caused more lasting damage.

There is still much to learn about the complex interplay between COVID-19 and the cardiovascular system, but some of the possible reasons behind this symptom include: 1 2

Overactive immune response. When the virus enters your body, your immune system attacks on what it believes to be an invader. To mount a defense, it floods your body with a type of protein called cytokine. These cytokines can communicate with one another and work together to kill the virus. But in some people, when the immune system releases cytokines, it releases too much. This causes a dangerous surge in inflammation that is likely to overwhelm your body. This is called a “cytokine storm.” This is a serious complication. Excessive inflammation attacks the virus and can hurt good cells and tissue and damage your organs, including your heart. A cytokine storm can also cause your heart’s regular rhythm to go haywire. This can lead to arrhythmias, which could be dangerous for your health. 

Reduced oxygen supply. Another possible explanation is that COVID-19 can cause hypoxia or a lack of oxygen in the body's tissues. When oxygen is reduced, your heart may beat faster to try to compensate.

Blood Clots. COVID-19 can cause hypercoagulability, an increased tendency for blood to clot. It may beat faster for your heart to pump blood through any blockages in the arteries. This can increase your risk for other severe cardiovascular complications, including heart attacks and strokes.

Changes to your heart rate can also happen for other common reasons, including: 3

• Dehydration
• Anxiety
• Medication
• Abnormal heart rhythm (arrhythmia)
• Fever

Palpitations are not usually a cause for concern, but getting medical attention is a good idea if you're worried about them. It's also worth getting a medical checkup if the palpitations last a long time, do not improve or worsen, or have a history of heart problems.

COVID-related heart palpitations can vary in duration and intensity depending on various factors, such as the initial infection's severity and pre-existing medical conditions. Heart palpitations related to COVID-19 can generally last from a few days to several weeks. 4

An elevated heart rate is also associated as a symptom of long COVID. Some studies estimate that 25%-50% of patients report tachycardia or palpitations persisting for 12 weeks or longer, and 9% report still having palpitations at 6 months. 5

If you suspect that you are experiencing heart palpitation or a high heart rate COVID, you want to first talk to your health practitioner. They’ll likely ask about your medical history, do a physical exam, and order lab tests. You may be referred to a cardiologist, a doctor specializing in heart treatment.

Some of the tests you may be given include: 6

• Electrocardiogram (ECG or EKG). This quick and painless test records the electrical signals in the heart and can indicate if the heart is beating too fast or too slow.
• Holter monitoring. This portable ECG device is worn for a day or longer to record the heart's activity during daily activities. It can detect irregular heartbeats that may not be revealed during a standard ECG exam.
• Echocardiogram. This non-invasive test employs sound waves to generate detailed images of the heart in motion, providing insight into how blood flows through the heart and heart valves and determining if a valve is narrowed or leaking.
• Exercise tests or stress tests. These tests usually involve walking on a treadmill or cycling on a stationary bike while monitoring the heart. They help reveal the heart's response to physical activity and whether heart disease symptoms occur during exercise. If exercise is not possible, medications may be used instead.
• Cardiac catheterization. This test can reveal blockages in the heart's arteries. A thin and flexible tube (catheter) is inserted into a blood vessel, typically in the groin or wrist, and guided to the heart. Dye is then pumped through the catheter to the heart's arteries, making them visible on X-ray images taken during the test.
• Cardiac CT scan. In this test, you lie on a table inside a circular machine, and X-ray images of your heart and chest are collected as the X-ray tube inside the machine rotates around your body.
• Cardiac magnetic resonance imaging (MRI) scan. This test utilizes a magnetic field and computer-generated radio waves to produce detailed heart images.

Several treatment options can be used to bring your high heart rate from COVID down based on your test results. These treatment options may include:

• Medications. Specific drugs may be used to normalize heartbeats
• Catheter ablation. A procedure where a doctor threads a catheter through the blood vessels to the heart to scar a small spot of heart tissue and block the pathway causing the arrhythmia. 
• Pacemaker. This device can override a fast heartbeat.

Additionally, it’s essential to take all necessary steps to support your overall health and manage any existing cardiovascular risk factors to prevent heart issues. You can take the following steps to protect your overall heart health: 7

• Do not smoke
• Eat healthy foods
• Drink little or no alcohol
• Cut back on caffeine beverages
• Exercise
• Maintain a healthy weight
• Manage stress
• Practice good sleep habits

Your heart is a vital organ, and any symptom of concern should merit a call to your physician, whether you have had COVID or not. By taking the necessary precautions and seeking medical attention as needed, patients can help reduce the risk of serious heart problems associated with COVID-19.

Q: Does coronavirus make your heart race?
A: COVID-19 can cause your heart to race or palpitate, especially during the acute phase of the infection. Studies have found that many patients with COVID-19 experience cardiac symptoms, including chest pain, palpitations, and rapid heartbeat (tachycardia), particularly those with a severe or critical illness.

Q: How does COVID affect the heart?
A: COVID-19 can affect the heart by causing inflammation of the heart muscle, abnormal heart rhythms, increased risk of acute coronary syndrome and blood clots, and long-term effects on heart function or chronic inflammation. People with pre-existing heart conditions may be at higher risk of developing complications from COVID-19.

Q: Does COVID increase heart rate?
A: COVID-19 can increase heart rate as a symptom of fever, which is a common symptom of the infection. Additionally, the virus can cause inflammation and stress on the body, which can also increase heart rate. However,  an increased heart rate is not always a symptom of COVID-19, and other factors such as physical activity or anxiety can also cause an elevated heart rate.

Q: What is a normal heart rate with COVID?
A: There’s no specific "normal" heart rate for people with COVID-19, as heart rate can vary widely depending on various factors, including age, activity level, and overall health. However, a normal resting heart rate for adults is typically between 60 -100 beats per minute.

Q: What is a dangerous heart rate with COVID?
A: Generally, a heart rate of more than 100 beats per minute at rest or an irregular heartbeat may be a cause for concern. However, it’s crucial to consult with a healthcare professional if you have any concerns about your heart rate or other symptoms related to COVID-19.