COVID-19 has significantly broadened the landscape of cardiac complications, challenging the notion that it is solely a respiratory disease. The SARS-CoV-2 virus can affect the heart both directly and indirectly—patients have presented with myocarditis, arrhythmias, acute coronary syndromes, heart failure, and thromboembolic events, sometimes even in those without underlying cardiovascular conditions.
Pathophysiologically, several mechanisms are at play: the virus may directly injure myocardial tissue, trigger widespread systemic inflammation, disrupt endothelial function, or promote a hypercoagulable state. Clinicians often rely on biomarkers such as troponins, BNP, and inflammatory markers to help identify and monitor cardiac involvement. Elevations in these markers typically signal more extensive cardiac injury, underscoring the importance of early detection.
Management strategies are multifaceted. Supportive care and close surveillance of cardiac biomarkers and imaging findings are foundational. For myocarditis or heart failure, guideline-directed medical therapies—ACE inhibitors, beta-blockers, and diuretics—are frequently utilized; in select cases, immunomodulatory treatments may be considered. Arrhythmias are addressed using antiarrhythmic agents and, when indicated, device-based therapies. Post-acute care, including structured follow-up and cardiac rehabilitation, is vital to assess for ongoing sequelae and to optimize long-term cardiac recovery.
In summary, early recognition, comprehensive monitoring, and individualized therapeutic approaches are crucial for mitigating the cardiovascular impact of COVID-19 and improving patient outcomes. Ongoing vigilance is warranted, as the long-term cardiac effects of SARS-CoV-2 infection continue to be elucidated.