Chest pain is a common symptom of COVID-19. You may experience chest pain that lasts beyond your initial COVID-19 infection, or that starts in the weeks after you had the virus. Some common Post-COVID chest-related symptoms are palpitations, dizziness, chest pain, and shortness of breath, which may be due to heart problems, or can also be caused by COVID-19.

It’s important to remember that even if you’ve had COVID-19 and are now experiencing chest pain, it may not be related to the virus. If you experience any new type of chest pain, it’s important to get medical advice, as chest pain can be a sign of something more serious, like a heart or lung problem.

WHAT DOES IT LOOK LIKE

A temporary increase in heart rate can be caused by many things, including fever, dehydration, pain, stress/anxiety and medications, to name a few. Symptoms of a rapid or irregular heart rhythm may include feeling your heartbeat rapidly or irregularly in your chest (palpitations), chest discomfort or feeling lightheaded or dizzy, especially upon standing.

Post-COVID, also known as Long COVID, may show symptoms of a condition known as Postural Orthostatic Tachycardia Syndrome (POTS). While POTS affects your cardiovascular system, it is not directly a cardiac problem. POTS is a neurological disorder that affects the part of the nervous system that regulates heart rate and blood flow. The syndrome can cause rapid heartbeats when you stand up, which can lead to brain fog, fatigue, palpitations, lightheadedness and other symptoms. If you are experiencing these symptoms after COVID-19 infection, seek medical attention.

Sad young afro woman suffering from acute pain in chest, grey background

POSSIBLE CAUSES

We’re still learning more about chest pain following COVID-19, but it seems likely that it can be caused by a variety of things. Although COVID-19 is primarily a respiratory or lung disease, it can also impact many other body systems, including the heart. Temporary or permanent damage to heart tissue can be due to several factors:

LACK OF OXYGEN:
As the virus causes inflammation and fluid to fill up the air sacs in the lungs, less oxygen can reach the bloodstream. The heart has to work harder to pump blood through the body, which can be dangerous, especially in people with preexisting heart disease.

MYOCARDITIS (INFLAMMATION OF THE HEART):
Many viruses (including the flu) can infect and damage the heart muscle directly, and COVID-19 is no exception. The body’s own immune response can also attack and damage the heart muscle.

COVID-19 also can cause blood vessel inflammation, damage to very small vessels and large or micro blood clots, all of which can compromise blood flow to the heart and other parts of the body.

STRESS CARDIOMYOPATHY:
Many viral infections can cause cardiomyopathy, a heart muscle disorder that affects the heart’s ability to pump blood effectively. When attacked by a virus, the body undergoes stress and releases a surge of chemicals called catecholamines, which can stun the heart. Once the infection resolves, the stressor has ended and the heart can recover.

SYMPTOMS

Chest pain may turn out to be nothing serious, but it’s important to seek immediate medical attention if you are experiencing the following symptoms of a heart attack, such as:

Moderate to severe chest pain

Chest pain that appears or worsens with activity

Chest pain associated with Ppalpitations or very low heart rate

Chest pain that worsens with change in position

Chest pain that is associated with excessive sweating and/or ashen color

New onset chest pain that is associated with new onset nausea or vomiting

Sudden feeling of pressure, squeezing, tightness or crushing under the breastbone

MANAGEMENT

If you think you may be having a heart attack you should seek urgent medical attention by phoning 911. Heart attack symptoms include:

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Sudden chest pain that lasts longer than 15 minutes.

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Sudden chest pain along with nausea or vomiting, sweating, lightheadedness or shortness of breath.

You should discuss any new chest pain with your healthcare team. Do not ignore chest pain brought on by physical exertion and relieved by rest. This may be angina.

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