Glenda Sexauer, 59, was diagnosed with heart failure when she was 46. But, it took nearly a year—all while her heart health was steadily declining—for doctors to realize what was wrong.She had several symptoms, including relentless fatigue, bloating, nausea, and weight gain she couldn’t explain. Initially, she was diagnosed with an autoimmune condition and pneumonia before her doctor referred her to a cardiologist. She was hospitalized for several weeks and had a pacemaker and defibrillator placed in her chest. Her road to recovery took several years—she still takes multiple medications each day and relies on her pacemaker—but she credits her active lifestyle for getting her through it all.Heart failure affects about 3.6 million women in the United States—but there is a huge disparity in research between men and women with heart failure. Nearly 50% of people admitted to the hospital with heart failure are women,1 yet only 25% of women are involved in heart failure studies.2After her experience, Sexauer became a community educator with WomenHeart, a nonprofit organization that educates women with heart disease about the signs of heart failure. Here’s her story, as told to writer Erica Sweeney.—I’ve always been active. I exercised regularly, ran marathons, and once did a two-day, 150-mile bike ride. But, when I was 46, I noticed that I wasn’t feeling like myself anymore. I had gained some weight and was tired all the time. I slept a lot and felt bloated. I just knew something wasn’t right. I went to my gynecologist first, thinking my symptoms could be pointing to menopause, but my hormone testing ruled that out. Then, I researched my symptoms online and thought it might be my thyroid acting up. My doctor diagnosed me with the autoimmune disease Hashimoto’s thyroiditis, an autoimmune condition that can cause symptoms like fatigue, weight gain, and muscle weakness. I thought, “OK, that’s what it is.”I continued feeling tired all the time, though, despite taking medication for Hashimoto’s. I had a lot going on in my life then, too. My son had just gone away to college and my mother-in-law was living with us. I was working as a vice president of a financial services company. My mom was also really sick; she had Alzheimer’s and was nearing the final phase of her life. So, I thought maybe I was just experiencing anxiety.Then, I started feeling a funny sensation in my chest when lying down. It was kind of like I could hear my heart gurgle. A couple of nights I had to sit up to sleep. After my mother passed away, something else gave me pause. I was at her funeral when I coughed up some stuff that didn’t look right. I saw my primary care doctor and told him I thought I had pneumonia. He confirmed I had a little bit of fluid in my lungs and prescribed medication. I never had a fever, which, looking back now, was a big hint that I didn’t have pneumonia. No one ever thought I had heart disease.Then, I finally got a heart failure diagnosis.To celebrate our 25th wedding anniversary, my husband and I planned a trip to Hawaii. We decided to go, even though I wasn’t feeling great. I couldn’t eat much and felt nauseated. When we got there, I slept so much. I had to sit and rest after walking up just two steps. We had all these activities planned and had to keep canceling because I just couldn’t do them—and that’s not like me. On the day we came home, I put all of my symptoms into a health checker online and it suggested I had a heart problem. At the time, we laughed because I was really pretty healthy.
Because of this, race itself isn’t the end all be all when it comes to heart failure risk. It is in no way as simple as “heart failure is passed on genetically in certain groups,” says Dr. Morris. Here’s why: Since some genetic mutations that are linked to heart failure—such as transthyretin amyloidosis, which can cause a buildup of proteins in the body that can lead to heart failure—are most commonly found in people of African ancestry, it follows that this mutation may be more prevalent in people who self-identify as Black, she explains. But there are many other complex factors at play, including generations of social dynamics, like racism and segregation. “As an African American, I am more likely to have inherited certain traits,” Dr. Morris explains, but that is, in part, because society “kept races apart from each other—intentionally.”There are also “traditional” risk factors to consider.“Traditional” risk factors refer to the more common things we know contribute to the risk of heart failure, thanks to evidence gathered in research, says Dr. Khan. For example, we know that high blood pressure is a key risk factor for heart failure—your heart has to work harder if your blood pressure is high, which can stiffen it or weaken it over time, according to the Mayo Clinic. And about 55% of Black Americans have high blood pressure, per the American Heart Association (AHA).Other conditions and risk factors that fall into this category include having type 2 diabetes; carrying extra weight; not eating enough fruits, vegetables, and whole grains; and being sedentary. These factors can help your doctor evaluate whether you’re at an increased risk of heart failure, Dr. Khan says. And nearly all of them also disproportionately affect communities of color, per the AHA.Of course, there isn’t a simple explanation as to why high blood pressure, diabetes, and obesity, for example, are so prevalent in Black communities. “It’s very hard to separate the reasons out because they are very interconnected,” says Dr. Khan. Again, some of it may come down to genetics. Additionally, these so-called traditional risk factors are prevalent in communities of color because of societal factors.Social determinants of health are a big deal.The term social determinants of health refers to “the conditions in the environments where people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks,” per the US Department of Health and Human Services.Social determinants of health include things like someone’s financial stability, their access to and quality of health care, their ability to find nutritious foods and exercise opportunities in their community, as well as the likelihood of facing racism, discrimination, and violence in their everyday life. In a 2022 paper coauthored by Dr. Khan and published in Clinical Cardiology, researchers note that a variety of social determinants of health have been associated with heart failure risk, including things like a lack of quality education, living in a low-income household or community, living in a region with a poor public health infrastructure, and a lack of health insurance, among others.2
Sprinting through the final minutes of your run, the stressful seconds leading up to a big presentation, or watching Stranger Things alone in the dark: These are all times when you might feel like your heart rate won’t go down. But just going about your daily life shouldn’t lead to a racing heartbeat. Typically, your heart is part of a fine-tuned system that keeps the essential organ beating at a certain rhythm. So when the beats unexpectedly speed up, it’s understandable to feel concerned that something more serious might be happening to you.Your heart performs an incredible daily balancing act that’s crucial to keeping you alive and healthy. “The heart beats because of electricity,” Shephal Doshi, MD, director of cardiac electrophysiology at Providence Saint John’s Health Center in Santa Monica, California, tells SELF. No, not the type that keeps your lights on, although that would be interesting. Instead, these are electrical impulses from a group of cells in your heart’s right atrium (chamber) that act like your own internal pacemaker. These cells, known as your sinoatrial (SA) node, tell your heart when and how to beat in order to send oxygen-rich blood throughout your body.Sometimes, your body can signal your heart to beat faster, and the SA node responds. Other times, signals start coming from other parts of the heart, causing it to speed up. Whatever the reason, a racing heart rate, or heart palpitations, can make you feel anxious, among other unpleasant symptoms.A racing heart rate has many potential causes, very few of which signal something life-threatening like a heart attack or heart failure. What is important, however, is how your racing heart makes you feel and how often this switch in pace happens. Here are the most common reasons it feels like your heart rate won’t go down—and when you should consider seeing a doctor.What is a “healthy” resting heart rate? | Common causes of a fast heart rate | When to see a doctorFirst, how do experts typically define a “healthy” heart rate?A “normal” or healthy resting heart rate for most adults ranges from 60 to 100 beats per minute, according to the US National Library of Medicine. Between these rates, your heart can pump the oxygen-rich blood it needs to your vital organs. If you’re very physically active—say, you’re an avid runner—you may find your resting heart rate is much lower (sometimes as low as 40 beats per minute). This is because exercise, especially cardiovascular exercise, helps your heart work more efficiently, meaning it can squeeze out more blood at a slower rate, per the Mayo Clinic.A resting heart rate that’s consistently higher than 100 beats per minute or lower than 60 beats per minute (if you’re not an athlete) can signal an underlying health issue, according to the Mayo Clinic.Back to topWhat are the most common causes of a fast heart rate?Normally, your body’s systems run on autopilot, thanks to your autonomic nervous system, which regulates all the vital functions you don’t really need to think about. “This includes things like your heart rate, blood pressure, sweating, urination, and various gastrointestinal functions,” Brent Goodman, MD, a board-certified neurologist at the Mayo Clinic in Phoenix, tells SELF.Sometimes, though, certain lifestyle habits, situations, or even health conditions can cause your heart to start beating very rapidly or irregularly. Here are a few common culprits to keep on your radar.1. You’re feeling very stressed.Let’s be real: With everything going on in the world, there’s an extremely good chance you’re stressed right now. When you encounter something stressful, your body releases a surge of norepinephrine, also known as adrenaline, Camille Frazier-Mills, MD, a cardiologist at Duke Electrophysiology Clinic, tells SELF. Receptors in your heart respond to this trigger and can make your heart rate pick up.1If you can’t immediately solve whatever’s making you stressed (which is hard to do on a good day, let alone in the chaotic reality we live in), try deep breathing exercises to at least help you feel better in the moment. The Mayo Clinic suggests taking deep breaths through your nose so that you feel your stomach rise instead of your chest, and exhaling through your nose as well. Focus on your breath and the rise and fall of your abdomen throughout. (If you’re looking for a more detailed exercise to try, check out these relaxing deep breathing videos.)2. You’ve had a lot of caffeine.While most people can handle a certain level of caffeine just fine, overdoing it can make your heart rate speed up. “A bunch of patients come to see me with an elevated heart rate, then they tell me they drink multiple highly caffeinated beverages daily,” Dr. Mills-Frazier says. “They’re revving themselves up.” This is most likely to happen if you’ve had too much caffeine, but it could also happen in response to small amounts if you’re just sensitive to this stimulant.According to the US Food and Drug Administration (FDA), it’s technically safe for adults to have up to 400 milligrams of caffeine a day, or around the amount in four or five cups of coffee. If that sounds like a lot to you, it may be, since there is a wide range in how sensitive certain people are to the effects of caffeine and in how fast it gets broken down in the body. Certain medications and health conditions may also make you more sensitive to caffeine, including being pregnant. Try cutting back on caffeine gradually to see if it reduces your racing heart (just don’t try to cut it out cold turkey if you rather not deal with the unpleasant side effects of caffeine withdrawal). If that doesn’t help, get in touch with your doctor.3. You smoke.Smokers (tobacco, cannabis, marijuana, you name it) tend to have higher resting heart rates than those who don’t smoke, according to a 2015 study published in Circulation: Cardiovascular Genetics. Although doctors don’t exactly know why this happens, an increase in heart rate from smoking could come with other cardiovascular complications, including a heart attack.24. You have cold- or flu-like symptoms, like a fever.If your pounding heart is accompanied by typical cold- or flu-like symptoms, such as a fever, coughing, and sneezing, a viral illness might be the likely culprit. Battling any type of infection requires your body to work harder than usual, and that includes making your heart beat faster in order to fight for homeostasis (its usual stable condition) and kick the infection to the curb, Dr. Mills-Frazier says.
Tiara Johnson, 32, was diagnosed with heart failure when she was just 26 years old. At first, her doctors wrote off her symptoms and told her it was nothing to worry about.Those symptoms—high blood pressure, shortness of breath, and fatigue—set in toward the end of her pregnancy. She was put on blood pressure medication and sent home after her daughter was born. When she went back to the hospital with persistent symptoms, she was told they were normal for someone who was postpartum. So Johnson just kept pushing through, hoping things would improve with time.Instead, everything just got worse. After passing out in the parking lot at work and being sent to the ER, she learned the true cause of her symptoms: end-stage congestive heart failure. Here’s her story, as told to health writer Korin Miller.It all started at the end of my pregnancy with my second child. I had a completely normal experience—until the last week. My blood pressure skyrocketed out of nowhere and my fingers became so puffy that I couldn’t wear my wedding ring. I was diagnosed with preeclampsia, a serious complication of pregnancy that causes high blood pressure and signs of liver or kidney damage; I was given medication to control hypertension—it didn’t work. A few days later, my doctor decided to induce me, but during labor I felt like something still wasn’t right and I couldn’t catch my breath properly. I expressed my concerns to the medical staff, but I was repeatedly told that everything was fine. So I assumed I was just overreacting, even though I truly felt like something was off.I had my daughter on July 31, 2015. When we went home, I still felt like I couldn’t breathe and it didn’t get better when I laid down or sat up. A few days later, I was in the shower and I felt like I was drowning, so I went back to the hospital. There, I was told I was fine and that this was a normal feeling after you have a baby due to fluid buildup in the body.I felt a little bit better when I went home, but I kept dealing with shortness of breath. I couldn’t lift my baby, I felt exhausted all the time, and I was sleeping a lot. I couldn’t walk for any long periods of time. But, because I was told that this was normal, I just dealt with it.Things changed on October 9, 2015. I passed out in the parking lot where I worked and was sent in an ambulance to a different hospital’s ER. There, I was given a series of tests and finally found out why I had been feeling unwell for the past three months: I had congestive heart failure and it was end-stage, meaning my heart was barely functioning. In fact, it was functioning at just 10% of its normal capacity.
Following her diagnosis, Bieber was advised to undergo PFO closure, a procedure that involves a catheter guiding the placement of a permanent implant to seal the hole in the heart wall, according to the Cleveland Clinic. Fortunately, the surgery was a success and Bieber is now healing well. “I’m recovering really well, really fast. I feel great,” the model tells fans in her video. “The biggest thing I feel, honestly, is really relieved that we were able to figure everything out, that we were able to get it closed, that I will be able to just move on from this really scary situation and just live my life,” Bieber said. Bieber is fortunate that both she and her husband, singer Justin Bieber, acted quickly after noticing her initial symptoms. According to the Mayo Clinic, some symptoms of a stroke can include difficulty speaking and understanding speech, paralysis or numbness of the face, arm, or leg (typically on one side of the body), a drooping side of the face, blurred or darkened vision, severe headache, or trouble walking. In her YouTube video, which currently has more than two million views, Bieber revealed that difficulty speaking, numbness in her arm and fingers, and drooping on one side of her face were all symptoms she experienced: “I couldn’t get a sentence out. I couldn’t get the words out,” Bieber said. It was then she knew she was having a stroke. “I’m really scared, I don’t know what’s going on,” Bieber said.Fortunately, by the time she was admitted to the hospital, she was already feeling more like herself. “By the time I got to the emergency room, I was pretty much back to normal. Could talk, wasn’t having any issues with my face or my arm,” Bieber said. Though scary, a TIA thankfully is only a temporary period of stroke-like symptoms and doesn’t cause permanent damage. But, around one in three people who experience a TIA will go on to suffer a full-blown stroke, usually within the year that follows the TIA. Seeing a medical professional immediately after a TIA is critical to potentially prevent a future stroke.According to the American Stroke Association, one of the best ways to spot a stroke is to remember the FAST acronym:(F) Face drooping: Is one side of the face drooping or numb, or is the smile uneven?(A) Arm weakness: Is one arm weak or numb? When the arms are raised, does one drift downwards?(S) Speech difficulties: Is speech slurred?(T) Time: It’s time to phone 911 if you notice any of these issues.Rapid diagnosis (within three hours of the onset of symptoms) gives an individual a higher chance of responding to treatment, as per the CDC, meaning it’s important to seek medical attention as soon as possible.Related:
Heart failure is one of those conditions that you rarely (or ever) think about—until it personally affects you. Maybe someone you love was recently diagnosed with heart failure or your doctor warned you about it during a recent physical. Whatever the reason is for it to be on your radar, heart failure sounds pretty scary. You might think it means that your heart suddenly stops working, but heart failure is actually a gradual process in which your heart doesn’t work as efficiently as it should, and it affects roughly 6.2 million people in the U.S., according to the Centers for Disease Control and Prevention (CDC). Here’s everything you need to know about this condition, including what causes heart failure in the first place.What is heart failure? | What are the risk factors for heart failure? | Who is at risk for heart failure? | What are the heart failure stages?What is heart failure?Your heart is tasked with a big job: pumping oxygen and nutrients to all of your organs. Heart failure happens when your heart muscle can’t keep up with the demands of its role, and the rest of the body starts failing, Tariq Ahmad, MD, MPH, associate professor of medicine at Yale Medical School and medical director of advanced heart failure at Yale Medicine, tells SELF.Heart failure can involve the left, right, or both sides of a person’s heart. Left-sided heart failure happens when things go wrong in the left ventricle, which is the muscle’s main pumping chamber. There are two types of left-sided heart failure: systolic heart failure, which means the left ventricle can’t push blood out very well, and diastolic heart failure, which is when the heart is stiff so it can’t relax and fill with enough blood in between beats, according to the National Heart, Lung, and Blood Institute (NHLBI). When blood doesn’t pump in and out of the heart effectively enough, “congestion” can happen. (That’s why heart failure is also sometimes called congestive heart failure.)Right-sided heart failure usually occurs as the result of left-sided heart failure. When both sides are affected the condition is called biventricular heart failure. That said, right-sided heart failure can happen on its own if you have a condition that affects the lungs, such as chronic obstructive pulmonary disease, which causes lung damage.1As the heart gets weaker, people who have developed heart failure may experience the following symptoms, per the National Library of Medicine (NLM):Swelling in your feet, ankles, legs, or abdomen: This can happen because poor circulation causes water and other fluids to build up in the body.Wheezing or coughing: Fluid may build up in the lungs when the heart doesn’t contract properly, causing coughing fits.Shortness of breath: You may be huffing and puffing more than usual when doing everyday activities like walking. This can result from fluid build-up in the lungs or from a lack of oxygen-filled blood.General fatigue: Being robbed of oxygen can really deplete your body.2 “It’s like going from an 800-horsepower engine to one with 100 horsepower,” Dr. Ahmad says.Because heart failure can affect different parts of the heart, symptoms may vary from person to person. Some people might not have any symptoms at all. Heart failure happens in stages, so symptoms can change or worsen over time, according to the Cleveland Clinic.Back to topWhat are the main causes and risk factors of heart failure?Heart failure can happen any time the heart is severely strained or damaged. And that can happen in numerous ways:Coronary artery diseaseThis is the most common form of heart disease, and it occurs when cholesterol, which is a type of fat, builds up in the arteries. As cholesterol continues to accumulate, the coronary arteries narrow and start to inhibit blood flow, according to the CDC.DiabetesDiabetes happens when a person’s blood-glucose (or sugar) levels are higher than the recommended range. This occurs when your body doesn’t make enough insulin (a hormone that regulates blood sugar) or when your body can’t use the hormone efficiently, according to the CDC. Over time, high blood sugar can lead to complications such as high blood pressure and heart disease.High blood pressureMedically known as hypertension, high blood pressure is used to describe the force of blood against artery walls. Hypertension is one of the most common causes of heart failure because it makes the heart work so much harder than it should need to, according to the NLM.Heart attackA heart attack occurs when the heart doesn’t get enough blood or oxygen. “The heart muscle needs oxygen to live,” Dr. Ahmad explains. “If the heart doesn’t get that blood flow, the muscle will die and it won’t be able to come back.” After a heart attack, some people’s hearts may be working at a reduced capacity, which can lead to heart failure.Congenital heart defects (CHD)Sometimes, a person’s heart doesn’t develop properly before birth, resulting in a congenital heart defect, according to the CDC. There are numerous types of CHD, and some may be minor, while others can negatively affect blood flow.InfectionsThe immune system fends off viruses by triggering inflammation throughout the body. In rare cases, that inflammation can damage the heart, according to the Mayo Clinic. This is called myocarditis, and it most often leads to left-sided heart failure.Infection can also affect the heart more directly. For example, bacterial infections may cause germs to stick to and ultimately damage the heart valve, which is known as endocarditis, according to the Mayo Clinic. Generally, this happens when people already have heart damage.Heart valve diseaseSometimes, the heart valves have a hard time opening and closing. This can happen for a variety of reasons, such as being born with a heart defect or getting a severe infection like the flu, which can lead to heart inflammation.ArrhythmiasAbnormal heart rhythms, medically known as arrhythmias, simply mean the heart beats very quickly or slowly at rest. According to the Mayo Clinic, a fast resting heart rate is defined as greater than 100 beats per minute, while a slow resting heart rate is below 60 beats per minute. Everyone experiences a fast or slow heart rate at some point. For example, heart rate generally declines during sleep. But sudden consistent changes in heart rate can indicate an underlying issue, like diabetes or coronary artery disease, which can potentially cause arrhythmias.Sleep apneaSleep apnea (when you stop breathing periodically throughout the night) deprives the body of oxygen, which can eventually lead to heart failure, according to the NHLBI. There are three types of sleep apnea, and they can all contribute to developing high blood pressure and structural heart changes due to oxygen deprivation, according to the Cleveland Clinic. Sleep apnea can often cause right-sided heart failure, but it can worsen left-sided heart failure as well.Metabolic SyndromeMetabolic syndrome refers to several conditions, including high blood pressure, excess body fat around your stomach, elevated blood sugar, high triglycerides (a fat found in the blood), and low HDL cholesterol levels. Together, these issues can increase your risk of developing medical conditions, such as heart disease and diabetes, according to the NHLBI.Peripartum cardiomyopathyAlso known as postpartum cardiomyopathy, this is a rare form of heart failure that can impact people who are pregnant during their last month of pregnancy and up to several months after giving birth, according to the American Heart Association. The heart chambers get bigger and the heart gets weaker, decreasing blood flow and oxygen to other organs. People with elevated blood pressure, Black people, and people who are medically considered overweight have a higher risk of developing this form of heart failure.MedicationsCertain medications can potentially damage the heart muscle, Sanjiv J. Shah, MD, director of the Heart Failure with Preserved Ejection Fraction Program at Northwestern University Feinberg School of Medicine, tells SELF. Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can cause water retention, which interferes with blood flow, increasing your risk of heart failure, heart attack, and stroke. Even certain meds to treat high blood pressure can actually increase the risk of heart failure, as can some chemotherapy drugs. Talk to your doctor to understand the risks versus the benefits of taking these medications.
The fluid build-up can also cause swelling in your abdomen, which Dr. Solanki says is usually a sign that the right side of your heart is having trouble.5. Nausea and lack of appetiteWhen your abdomen gets swollen from excess fluid, it makes it tough to have much of an appetite. “Many people with this heart failure symptom are not able to eat much and may have nausea,” Dr. Wald says.6. A rapid or irregular heartbeatAs heart failure progresses, the organ often tries to overcompensate by beating faster to increase circulation in the rest of your body. “People may start feeling heart palpitations or irregular beats,” Dr. Solanki confirms.7. Constant coughing or wheezingThis is also due to fluid and blood build-up in your lungs, Dr. Solanki says. Coughing up pink-hued mucus due to blood, in particular, is often a sign that your heart failure has progressed to a more severe, advanced stage.28. Very fast, unexplained weight gainHere’s yet another sign of fluid build-up in your body. “If you see more than a two-pound weight gain in a 24-hour period, that’s a potential sign of an acute heart failure issue,” Jennifer Wong, M.D., cardiologist and medical director of Non-Invasive Cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, tells SELF.9. Difficulty concentrating or decreased alertnessPeople with severe heart failure may not be receiving enough blood flow to the brain, Dr. Wald says. As a result, your brain doesn’t get the sufficient oxygen it needs to function well, leading to problems with staying alert and focused. At this point, you may have low levels of sodium in your blood, and that can lead to confusion in some people, per the AHA.10. Chest pain“When your heart is pumping rapidly, but your upper-body circulation is not able to keep up, you can start developing chest pains,” Dr. Solanki says. What that pain feels like varies from person to person, but it can range from mild discomfort to a squeezing sensation to sharp, burning pain. Chest pain can also signal coronary artery disease linked to heart failure, a condition in which your arteries become very narrow or completely blocked, often leading to a heart attack, per the CDC.Back to topHow to use “FACES” to remember the symptoms of heart failureFACES is an easy mnemonic device and a quick way to remember some of the most common signs of heart failure:3FatigueActivities limitedChest congestionEdema or ankle swellingShortness of breathBack to topHow is heart failure diagnosed?First, your doctor will go through your medical history to identify any potential heart failure risk factors. Then, they’ll do a physical exam to listen to your lungs for signs of fluid build-up and your heart for specific noises that can be indicative of heart failure.After that, there are a slew of potential tests your doctor may recommend if they suspect you have heart failure symptoms, according to the Mayo Clinic:
New research published in the journal Nature Medicine has found that people with COVID-19 may be at “substantial” risk of heart complications for at least one year following testing positive. The heart complications can include blood clots, irregular heart rhythm, inflammation, heart attack, and heart failure. In some cases, the complications have even resulted in death. In the study, which was published last Monday, researchers analyzed data from the U.S. Department of Veterans Affairs (VA) health system, with the results of 153,760 people who tested positive for COVID-19 between March 2020 and January 2021 being taken into account. The researchers then compared them to two control groups of people who, to their knowledge, didn’t have COVID-19 at the time of data collection. One group was a group of 5.6 million people who accessed the VA medical system during the pandemic (the contemporary controls), as well as 5.8 million people (the historical controls) who accessed the VA system in 2017, before the pandemic. It is the first study to analyze such a large group in relation to cardiovascular outcomes after COVID-19. The researchers analyzed the health results of these nearly 154,000 veterans with COVID-19 and Compared to these two other groups, one year after the acute phase of infection—a time soon after the onset of infection when several physiological processes occur—patients who had been infected with COVID-19 were found to have increases in 20 different heart health issues. That included a 52% higher risk of stroke than the contemporary controls as well as a 63% higher risk for heart attack, a 69% higher risk for irregular heart rhythm, and a 72% higher risk of heart failure. “Because of the chronic nature of these conditions, they will likely have long-lasting consequences for patients and health systems and also have broad implications on economic productivity and life expectancy,” study co-author Ziyad Al-Aly, MD, of the VA St. Louis Health Care System and Washington University in St. Louis said on Twitter.Perhaps the most concerning finding in the research was that the heart-related risks were found to be common even in people who experienced COVID-19 in a mild form, such as those who were not hospitalized or in ICU care because of their symptoms. Plus, this higher risk for heart problems was also observed in people who are considered to be less vulnerable to the virus, like people under 65 years of age and not facing immunocompromising risks such as diabetes. In the study, researchers acknowledge that the “mechanisms that underlie the association between COVID-19 and development of cardiovascular diseases in the post-acute phase of the disease are not entirely clear.” Some of the potential mechanisms to consider include endothelial cell infection (the cells that line blood vessels and regulate exchange between the bloodstream and surrounding tissue) and the downregulation of ACE2 (an enzyme attached to the membrane of cells in the intestines, kidneys, and other organs). As the reasons are not yet entirely clear, further research is required. “Addressing the challenges posed by long COVID will require a much needed, but so far lacking, urgent and coordinated long-term global response strategy,” Dr. Al-Aly said on Twitter. “I am happy that the Cancer Moonshot is being re-launched. We need a Long Covid Moonshot.”
Even though congestive heart failure is a commonly used term, the details can get a bit confusing when you really dig into what it means. That’s because “congestive heart failure” isn’t a separate condition from “heart failure,” Dana Weisshaar, M.D., a cardiologist at Kaiser Permanente in Santa Clara, California, tells SELF. Rather, the term is used to describe a type of heart failure that results in fluid retention, or congestion, throughout the body. Oftentimes, heart failure causes fluid build-up, which is responsible for many of its hallmark symptoms. And this can have serious consequences—90% of people who are hospitalized due to heart failure are admitted because of the symptoms resulting from congestion, research shows1.However, even though congestive heart failure is seen frequently, medical professionals do not use the term synonymously with any type of heart failure, Dipti Itchhaporia, M.D., program director of heart failure disease management at Hoag Memorial Hospital Presbyterian and president of the American College of Cardiology, tells SELF. In fact, most medical experts have moved away from using this differentiator at all. “It’s a little bit of an archaic term now. We just tend to use heart failure as the term.”So, why is it important to understand these nuances of heart failure, anyway? For one, the condition is common. About 6.2 million adults in the U.S. have heart failure, according to the Centers for Disease Control and Prevention (CDC).Still a bit iffy on what congestive heart failure means for your health? Ahead, SELF asked cardiologists to break down what to know about a diagnosis, from symptoms to congestive heart failure treatment.What is congestive heart failure, and how is it different from other types of heart failure?First, it’s helpful to understand what’s going on in the body when a person develops heart failure in general. Despite what the name implies, heart failure means that your heart can’t pump enough oxygen-rich blood to keep your body running as it should—not that the organ stopped working, according to the CDC. If your heart isn’t functioning properly, everyday tasks like walking up a few stairs can become difficult, especially if you feel short of breath.When your heart struggles like this, it can affect your other organs too. “Many people with heart failure cannot eliminate fluids normally and hold onto volume rather than urinate out extra fluids,” Jennifer Haythe, M.D., associate professor of medicine and co-director of Columbia Women’s Heart Center, tells SELF. In this case, your kidneys don’t receive enough blood to filter extra fluid in your body into your urine, resulting in the “congestion” that characterizes congestive heart failure, according to the American Heart Association. This can happen suddenly (acute heart failure) or over time (chronic heart failure).It’s important to note that not everyone with heart failure will develop fluid overload. “I prefer to make the distinction that not all heart failure is congestive,” Dr. Weisshaar says.Back to topWhat are common congestive heart failure symptoms?Congestive heart failure symptoms can overlap with those of other types of heart failure—but you might also have some specific signs that there’s extra fluid in your body.According to the Mayo Clinic and the National Heart, Lung, and Blood Institute (NHLBI), some common heart failure symptoms include:Feeling very fatigued and weak when doing everyday activities.A rapid or irregular heart rate, even when you’re relaxing.Nausea, to the point where you can lose your appetite.Chest pain, or feeling tightness and heaviness in your chest.Bluish lips or fingers, which happens when your blood is extremely low in oxygen.
Reports of new research suggest an increase in a medical phenomenon colloquially known as broken heart syndrome during the COVID-19 pandemic. And experts say this stress-induced heart health condition is mainly impacting women. Broken heart syndrome is a generally rare, typically temporary heart condition triggered by sudden, intense emotional or physical stress, according to Deepa B. Iyer, M.D., assistant professor of medicine at Rutgers Robert Wood Johnson Medical School and primary physician on the Advanced Heart Failure, VAD and Transplant Team at Robert Wood Johnson University Hospital. This stress can lead to rapid-onset cardiomyopathy, or weakening of the heart muscle. The syndrome was first identified in Japan and is hence referred to as “Takotsubo cardiomyopathy.” “Takotsubo is a word for an octopus trapping pot used by Japanese fishers which has a narrow neck and a round wide bottom. This pot resembles the shape of the weakened left ventricle of the heart when seen on cardiac echocardiograms or other imaging studies in these patients with broken heart syndrome,” Dr. Iyer tells SELF. (This health issue is also known as stress cardiomyopathy.)On February 7, ABC News reported that research teams at Cedars-Sinai in Los Angeles, Johns Hopkins University, and the Cleveland Clinic have all been tracking “a recent surge in cases” of this syndrome during the pandemic. Although the data collection is still in progress, past research on this topic during the pandemic backs this up. In a July 2020 JAMA Network study, researchers found that cases of broken heart syndrome had increased after COVID-19 emerged. The researchers analyzed data from 1,914 patients at two Cleveland Clinic hospitals with acute coronary syndrome (a range of conditions linked to sudden decreased blood flow to the heart). Some had acute coronary syndrome pre-COVID, and others presented with the syndrome during COVID. The researchers found an incidence of 7.8% of stress cardiomyopathy during the pandemic, compared with before the pandemic, when incidences ranged from 1.5% to 1.8%. “It has been an underrecognized and misdiagnosed condition, and the emotional and physical stressors during the COVID pandemic have resulted in a resurgence of reported cases,” Dr. Iyer says.While the study authors were careful to point out that the results cannot necessarily be generalized for various reasons—the patients only representing Northeast Ohio, for instance—they did suggest a few reasons for the potential connection between the pandemic and broken heart syndrome. Importantly, none of the people with stress cardiomyopathy in the study had COVID-19. But the experts believe that COVID-related factors like income loss, unemployment, and grieving loved ones could be behind the increase. Jennifer Wong, M.D., a cardiologist and medical director of non-invasive cardiology at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, has treated many patients suffering from the syndrome, particularly during the pandemic. “I’ve had numerous patients who are attending a funeral and have these symptoms,” Dr. Wong says. “The pandemic has been a stressful situation, so it’s not surprising that conditions directly affected by mental stress would increase. When there’s a situation of increased stress, we do tend to see these sorts of stress-induced heart conditions spike,” Dr. Wong tells SELF.