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COVID-19 Long-term Cardiac Sequelae

Persistent cardiovascular symptoms beyond 12 weeks of acute SARS-CoV-2 infection

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Internal Medicine department. Book Appointment →

What is COVID-19 Long-term Cardiac Sequelae?

Cardiac long-COVID encompasses a heterogeneous spectrum of dysautonomia (POTS), inappropriate sinus tachycardia, microvascular endothelial dysfunction, residual myocarditis and arrhythmic phenotypes persisting beyond 12 weeks after SARS-CoV-2 infection.

Pathophysiology integrates direct viral injury, persistent inflammation, autoimmunity, microthrombi, autonomic dysregulation and deconditioning, often unmasked by orthostatic stress or exertion.

Workup combines symptom-driven history, supine-standing heart rate and blood pressure, ECG, echocardiography, ambulatory monitoring and selective cardiac MRI; biomarkers include hs-troponin, NT-proBNP and CRP.

Symptoms

Persistent palpitations or rapid heart rate
Exercise intolerance and post-exertional malaise
Chest tightness or atypical angina
Light-headedness on standing (orthostatic intolerance)
Reduced functional capacity and fatigue

Risk Factors

Severe acute COVID-19 with hospitalization
Pre-existing autonomic disorder or migraine
Female sex and younger adults (POTS)
Underlying cardiovascular disease
Prolonged immobilization and deconditioning

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • New chest pain, syncope or persistent dyspnea
  • Resting heart rate above 100 bpm
  • Marked drop in exercise tolerance
  • Suspected orthostatic intolerance
  • Abnormal cardiac investigations (high troponin, MR scar)

Treatment Methods

01
Structured graded exercise with autonomic safety thresholds
02
Hydration and sodium supplementation for POTS
03
Beta-blockers, ivabradine or fludrocortisone in selected cases
04
Treatment of microvascular angina (statin, ACEi, anti-anginals)
05
Cardiac MRI follow-up for myocarditis sequelae
06
Multidisciplinary long-COVID rehabilitation clinic

Which Department to Visit?

You can visit our Enfeksiyon Hastalıkları department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Enfeksiyon Hastalıkları Department

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You can make an appointment with our specialists or contact us for your concerns.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.