On another COVID thread, somewhere, I posted links to a couple of articles about long-COVID. The import was that significant inflammation (Cytokine Storm) was triggered by the virus, and that it doesn’t always resolve properly.
If the inflammation doesn’t resolve ‘normally,’ it can leave scar tissue (fibrosis) in place of healthy myocardium.
Think about blowing up a balloon. Now, think about sticking a balloon inside of a beer bottle, and then trying to inflate it.
For a cohort of these long-COVID patients, their heart muscle has likely basically stiffened and become less able to properly relax.
These are difficult findings to discern without a very high index of suspicion. Even cardiac MRI can miss it, because it can be a ‘diffuse’ process (ie, spread throughout the heart). The cMRI tends to best describe differences.
Echocardiograms may elicit some abnormalities (again: requiring a high index of suspicion), but this kind of cardiac pathology can often only be diagnosed invasively, via Right Heart Catheterization and Endomyocardial Biopsy – not something routinely performed in ‘fairly healthy’ patients.
I haven’t looked to see if these studies have been repeated and the results reproduced, but my guess would be … this is still happening.
And the result can be tantamount to heart failure, though probably what’s called HFpEF – Heart Failure with Preserved (ie, normal) Ejection Fraction.
And some cardiologists, seeing a patient with a normal ejection fraction, assume everything is normal.
Even when it decidedly is not.
DAMHIKT.