While COVID-19 is primarily a respiratory illness, we know now that it can affect many parts of your body, including your heart. And it’s possible that these heart problems can turn into long-haul COVID symptoms that last for months, a year or even more.

So what can you do to keep your heart healthy? We cover symptoms that could indicate a heart problem after COVID-19, when to get help and different types of treatment.

What are symptoms of heart problems after COVID-19?

There are several heart-related symptoms that you could experience after COVID-19, including chest pain, shortness of breath, a fluttering heartbeat, dizziness, sudden weight gain and unexplained swelling in your legs or feet.

It’s important to note that these heart-related symptoms can also be signs of heart disease. A large study shows you may have an increased chance of heart disease if you’ve recovered from COVID-19, especially if you were hospitalized or in an intensive care unit when you were sick.

So, it’s important to be on the lookout for the symptoms below and make an appointment with your primary care doctor if you think you’re having heart troubles.

Chest pain after COVID-19

The following are distinct types of chest pain, and it’s possible that they can all be symptoms of long COVID.

Chest pain caused by muscle soreness

Widespread muscle soreness can be common in long COVID and may affect your chest muscles. If muscle fatigue after COVID-19 is the cause of your pain, you may feel tender across your entire chest or in a specific area.

When muscles are the cause of your pain, you may feel worse when you stretch or turn your head. This type of chest pain can also happen when you start a new exercise routine that uses your chest muscles, like boxing.

Since this pain is caused by your muscles, it’s usually nothing to worry about, and should go away on its own.

Chest pain caused by inflammation

Chest pain from inflammation is usually sharp and gets worse when you take a breath in. Usually, the cause is inflammation in the lining of your lungs. COVID-19 can cause inflammation of the heart muscle, a condition called myocarditis. According to the Centers for Disease Control and Prevention (CDC), you are 16 times more likely to have myocarditis if you were sick with COVID-19.

In many cases, myocarditis after COVID-19 is mild, and most people don’t have any symptoms. But you can have slight chest pain with mild myocarditis. If the inflammation is more severe, it can result in sharp chest pain, as well as other symptoms like heart palpitations, shortness of breath and fatigue.

Depending on the severity of your myocarditis and your personal health factors, it can take months for the inflammation, and the associated chest pain, to go away.

Chest pain from narrowed or blocked arteries

This type of chest pain feels like tightness or heaviness in your chest, and it’s one of the most recognizable signs of a heart attack. In some cases, COVID-19 can cause this type of chest pain.

COVID-19 targets the cells lining your blood vessels, and if these cells are damaged, there’s a possibility you could develop blood clots throughout your body. Depending on the location, some blood clots can disrupt the flow of blood to your heart, causing symptoms like chest pain.

Sometimes this type of chest pain isn’t related to your heart. For example, if you have a pulmonary embolism, a blood clot in your lungs, it can cause severe chest pain that feels like you’re having a heart attack even though your heart isn’t affected.

Both heart attacks and pulmonary embolisms can be life threatening. So, if you’re experiencing heaviness or tightness in your chest, call 911 right away.

Nonspecific chest pain

It’s also possible for you to have chest pain that is not related to heart disease, COVID-19 or any medical condition. This is often referred to as nonspecific chest pain. Nonspecific chest pain can feel dull or sharp, last for moments or hours, and show up in various locations.

If you’re experiencing unexplained chest pain that isn’t caused by exercise, keep track of your symptoms and make a primary care appointment.

Heart palpitations after COVID-19

If you’re experiencing heart palpitations after COVID-19, it can feel like your heart is beating too fast, fluttering or pounding. Your heart may be acting strangely for many reasons – it doesn’t necessarily mean that you have a heart condition. For example, dehydration, exercising and stress can affect your heart and how it beats.

Usually, you don’t need to worry if you occasionally get heart palpitations unless you also have other symptoms like chest pain. But recurring heart palpitations after COVID-19 can be heart arrythmias, which is a group of disorders that affect heart rhythm.

If your heart seems to be fluttering on a regular basis, take note of what you’re doing when your symptoms occur and make a primary care appointment to talk to your doctor. Most arrythmias are easily treated.

Shortness of breath after COVID-19

Breathing issues, such as shortness of breath, are possible after COVID-19. For example, you may feel like you can’t catch your breath after walking up the stairs, can’t take full breaths or need to rest more often than usual.

There are different reasons for lung symptoms after COVID-19, and some start with your heart. Shortness of breath can be caused by heart failure, a condition where your heart doesn’t work as well as it should. In some situations, the coronavirus weakens the heart muscle so it’s not able to pump as strongly.

If you get extra fluid in your lungs because of pulmonary edema during COVID-19, you’ll be more likely to have shortness of breath as a long-haul symptom. Often the cause of pulmonary edema is that the heart is too weak to circulate the blood it gets from the lungs. This results in fluid buildup in the lungs and can make it harder to breathe.

Another possible reason for shortness of breath is extreme fatigue caused by your body working hard to fight the coronavirus and get better.

If you’ve been struggling with shortness of breath for more than a couple of weeks, it may be a good idea to make a primary care appointment to talk to your doctor.

Dizziness and lightheadedness after COVID-19

Dizziness and lightheadedness are both long COVID symptoms that may be signs of heart problems. But there are other reasons why you may be dizzy or lightheaded after COVID-19.

COVID-19 infection can affect your brain and inner ear, making it more likely that you’ll experience dizziness. Plus, lightheadedness can be caused by many things, including dehydration, stress and low blood sugar.

Often these symptoms will go away on their own as you get better. However, if your dizziness and lightheadedness come with symptoms like shortness of breath, palpitations or chest pain, seek medical attention immediately.

Weight gain after COVID-19

Managing your weight after COVID-19 can be a struggle. People who were severely sick may still be trying to get back up to a healthy weight 3-6 months after COVID-19 infection. While others recovering from it might gain weight because they don’t have the energy to be active.

For weight changes to be a sign of heart problems, they usually need to be sudden and significant. If your weight increases 2-3 pounds in a day or 5 pounds in a week, make a primary care appointment – they can help you uncover the reason, whether it’s your heart or something else.

Unexplained swelling of legs, ankles and feet

Extra fluid sometimes collects in your body’s tissues, causing swelling (also called edema). Mild edema can be caused by many things, including medications, pregnancy, your diet and sitting for too long.

But edema can also be a sign of a serious medical condition such as congestive heart failure. If you have congestive heart failure, your heart won’t pump effectively, and this can cause blood to pool in the lower part of your body, resulting in swollen legs, ankles and feet.

Often edema goes away by itself. But if the swelling sticks around for more than a couple of weeks, make a primary care appointment. Seek immediate care for edema if you experience other symptoms as well, including chest pain, breathing problems, coughing up blood, fever, or skin that is red and warm to the touch.

Why do people get heart issues after COVID-19?

Scientists are still trying to determine why COVID-19 can cause lasting heart problems. If you had heart issues before you got sick, it’s possible that getting COVID-19 can make them worse.

But you may have heart problems after COVID-19 even if you didn’t have any issues before you got sick. You’re more likely to have COVID-19 heart damage if you were severely sick with the coronavirus and needed to be hospitalized with a ventilator. Heart problems can also occur after mild cases that didn’t require hospitalization – however, that’s much less common.

Who should I talk to about heart problems after COVID-19?

If you think you might be having a heart attack or other emergency, call 911 immediately. For ongoing care and treatment for heart symptoms, the best way to get started is to make a primary care appointment with your doctor.

Treatment for COVID-19 heart problems

After a thorough evaluation, your doctor will recommend how to manage heart problems after COVID-19. Their recommendations will likely include:

Staying active

Regular exercise can help make your heart stronger – 30 minutes most days is a good target. Ideally, your exercise program should include a combination of cardio, strength training and stretching.

Managing related conditions

Conditions like diabetes, high blood pressure, high cholesterol and obesity increase your risk of heart disease. Taking steps to manage these conditions can make a big difference. So continue to take any medicine you’ve been prescribed. If you’re overweight, try to drop a few pounds – often it only takes losing 5-10 pounds to start making a difference in your cardiovascular health.

Cardiac rehabilitation

Your primary physician will likely refer you to a cardiologist to confirm that your symptoms are clearly related to COVID-19 heart trouble and to define a treatment plan. If there is no active inflammation (myocarditis), your cardiologist may refer you for cardiac rehabilitation therapy. There are two key aspects to rehabilitation:

  • Education – You’ll learn about a range of topics, including lifestyle changes, signs of overexertion, the importance of a heart-healthy diet and tips for reducing stress.
  • Exercise – Your doctor and therapist will work with you to develop an exercise program you can do at home, at the gym or a cardiac rehab center to strengthen your heart.

Get help for your heart after COVID-19

It’s possible to start feeling normal again. If you think you might be experiencing heart problems after COVID-19, start by making an appointment with your primary care doctor. Depending on your heart health and risk factors, your doctor may recommend you meet with a heart health specialist or try cardiac rehabilitation.