A new study based on 18 COVID-19 patients from six hospitals in New York looked at the electrocardiography (EKG) readings to analyse the condition of their hearts. The purpose of the study was to understand complex treatment methods for people with COVID-19 and pre-exisiting heart problems.
The paper, published in the New England Journal of Medicine on April 17, noted an unusual phenomenon regarding how these patients experienced heart attacks. Despite elevated ST segments, half of these patients did not, in fact, suffer from a heart attack through artery blockage.
Myocardial Infarction (STEMI) is a condition when one of the main arteries supplying oxygen is blocked. This was not the cause of the heart attack in 56 percent, or ten, patients. The angiography revealed that “non-coronary myocardial injury” was the cause behind the heart attacks and it was not caused by the conventional artery blockage.
“As we continue to learn about the impact COVID-19 has to our heart, we have begun to identify unique and unusual effects. Some patients present with abnormal EKGs, which can classically look as an acute heart attack, but without a true finding of a blocked artery,” Dr. Satjit Bhusri, a cardiologist at Lenox Hill Hospital, told WebMD.
If not artery blockage, what caused these heart injuries? “Myocardial injury in patients with Covid-19 could be due to plaque rupture, cytokine storm, hypoxic injury, coronary spasm, microthrombi, or direct endothelial or vascular injury,” the team led by Dr. Sripal Bangalore, a professor of medicine at NYU Langone Health, stated in the paper.
Of all these patients, overall 13 or 72 percent of them died. Nine out of ten patients with noncoronary myocardial injury died, while four patients with myocardial infarction did not make it.
Drugs addressing blot clots may not work for half of these patients, hence the underlying complexity of these cases needs further investigation. Due to the high death rate, Bangalore said there is an urgent need to do more research to understand how COVID-19 affects patients with pre-existing cardiac conditions, all of whom displayed classic signs of a heart attack, either during the stay or upon hospital admission.
All the patients had a median age of 63 years and most of them were men. About 66 percent of the patients had high blood pressure, while 40 percent of them had high cholesterol and one-third of these patients had pre-existing diabetes.