While viral infection only increases the risk of cardiac arrest, other factors like smoking, high blood pressure, high cholesterol, diabetes, and a sedentary lifestyle, play a significant role.
Catching a flu may not end with just a cold, cough, and fever, it could also impact the heart. Viral infections can be a trigger for sudden cardiac arrest and can cause temporary or long-lasting damage to the heart tissues. Recently, a 25-year-old student from Hyderabad who was studying in Canada, died of sudden cardiac arrest on February 16, 2024. He had a fever since a week and had been suffering from a viral infection.
A study by Centers for Disease Control and Prevention, US published in 2020, reported that sudden, serious heart complications are common in adults hospitalized with flu. The study stated that almost 12% of adults hospitalized with influenza, had an acute cardiovascular event.
“Viral infections, especially certain types like influenza, cytomegalovirus (CMV), and human immunodeficiency virus (HIV), can increase the risk of heart attacks and other cardiovascular issues,” says Dr A Ravi Kanth, senior cardiologist, Kamineni Hospitals, L.B Nagar, Hyderabad. He said that these viruses contribute to heart attacks through various mechanisms, although the exact processes are not fully understood.
Covid-19 is also one such virus that affects the heart, says Dr Abhishek Singh, consultant cardiology, Manipal Hospital, Ghaziabad, Uttar Pradesh. Recalling the pandemic outbreak, he said, “We saw several young adults who had just recovered from covid and had no other risk factors, suffering from coronary artery diseases.”
How does viral infection lead to cardiac arrest?
Viral infections increase heart attack risk through inflammation, promoting atherosclerosis, a condition where there is a build-up of fats, cholesterol and other substances in the artery walls, said Dr Kanth. “They disrupt endothelial cell function, leading to clot formation. Infections destabilize arterial plaque, triggering clot formation if ruptured. Some viruses directly infect the heart muscle, increasing failure risk,” he said.
Infection can lead to dysfunction of endothelium, the inner layer of blood vessels which leads to cardiac arrest, says Dr Singh. “Viral infection can cause myocarditis, a condition that leads to inflammation of the heart muscles. This can lead to sudden rhythm disturbance, reduced function of the heart, and congestive heart failure,” he said adding that myocarditis can itself lead to sudden cardiac death.
According to Johns Hopkins Medicine, viral infection can lead to lack of oxygen causing inflammation and fluid buildup in the air sacs of the lungs, resulting in less oxygen reaching the bloodstream. Due to insufficient oxygen, the heart can fail by causing cell death and tissue damage. Viral infections can also cause cardiomyopathy, a heart muscle disorder that affects the heart’s ability to pump blood effectively.
Will mild infection also affect the heart?
Yes. Certain people could have had a mild viral infection with or without symptoms or even mild fever and may develop the risk of sudden cardiac arrest after two weeks of exposure to the infection or during the infection itself says Dr Mohan Murali Jangamsetty, interventional cardiologist, Apollo Spectra Hospital, Bangalore. “However, it may happen only in some people and not everyone as various factors contribute to it,” he said.
“In most myocarditis, post viral infection, people don’t consult the doctors until they have had episodes of loss of consciousness and palpitations. Often, these signs are not picked up in the initial diagnosis and only after a detailed examination and ruling out other causes, the heart conditions are revealed and by then, the person would have suffered with cardiac arrest,” explains Dr Jangamsetty.
Persistent viral infections, where the virus remains active in the body for a long time, are particularly dangerous, cautions Dr Kanth. “These infections can cause ongoing inflammation and damage to the cardiovascular system, increasing the risk of long-term complications such as heart attacks, heart failure, and arrhythmias (irregular heartbeat),” he said.
Dr Jangamsetty added that dehydration itself can cause sudden cardiac death due to the thickening of blood flow especially during the recovery from viral infection. Indirect effects of cardiac arrest also include electrolyte imbalances and heart stress.
How to reduce the risk of cardiac arrest?
While viral infections can increase the risk of heart attacks, they are just one of many factors that can contribute to cardiovascular disease, said Dr Kanth. “Not everyone who has suffered from viral infection will get cardiac arrest. Viral infection will only increase the chance, but it can be prevented when diagnosed early. It is crucial to look out for cardiac symptoms and consult your physician if you notice any,” said Dr Singh.
Dr Kanth said that other factors, including smoking, high blood pressure, high cholesterol, diabetes, and a sedentary lifestyle, also play a significant role. “Maintaining a healthy lifestyle, including regular exercise, a balanced diet, and avoiding smoking, is crucial for reducing the risk of heart attacks and other cardiovascular issues, especially in the presence of viral infections,” he said.
Treatment and diagnosis
Treatment of viral infections typically involves antiviral medications, supportive care, and management of symptoms, said Dr Kanth. “In cases where a viral infection is suspected of contributing to cardiovascular issues, additional treatments may be necessary to manage the heart-related complications,” he said.
According to Dr Jangamsetty, in any case of cardiac arrest, the history of the person is very important to assess and understand if he/she had any fever or exposure to viral infections or genetically passed down diseases to find out the reason behind the death.
Takeaways
- Viral infections not only affect the lungs and the respiratory system but also the heart.
- Not everyone who has suffered from viral infection will get cardiac arrest.
- Viral infections are just one of many factors that can contribute to cardiovascular disease. Other factors include smoking, high blood pressure, high cholesterol, diabetes, and a sedentary lifestyle.
