Cardiologist after COVID: when it makes sense to clarify the heart

A cardiologist is the right person to see after a COVID-19 infection or other serious infections if you notice new or persistent symptoms in your heart, circulation or general resilience. Many people do not feel fully fit again even long after the acute infection has subsided. Persistent palpitations, shortness of breath or a noticeable drop in performance can be very worrying. At our practice, we take these post-COVID symptoms very seriously and offer you a structured assessment by our experienced cardiologist Dr. Raphael Bruno to find or rule out organic causes.

How to see a cardiologist after COVID: Which symptoms are relevant?

Not every form of fatigue after an infection indicates a heart problem. However, there are specific symptoms that should prompt you to make an appointment with a Cardiologists after COVID-infection.

Seek medical advice if the following symptoms persist or reappear weeks after the infection:

• Palpitations (tachycardia): An inappropriately fast pulse at rest or at the slightest exertion such as getting out of bed.
• Heart stumbling (palpitations): An irregular, fluttering or „jumping“ heartbeat.
• Chest pain: Any form of pressure, tightness or stinging in the chest that is new.
• Shortness of breath (dyspnea): The feeling of being „out of breath“ even with light everyday activities such as climbing stairs.
• Dizziness and circulatory instability: In particular „blacking out before the eyes“ when standing up quickly.
• Persistent, pronounced weakness in performance: Massive exhaustion (fatigue), which differs from normal tiredness and hinders the return to everyday life.

Your first appointment with a cardiologist after COVID: what can you expect?

The first and most important step during your appointment with a Cardiologists after COVID is a detailed discussion. We know that symptoms are often diffuse and difficult to describe. Dr. Raphael Bruno will listen to you attentively and ask specific questions in order to classify your symptoms.

Typical questions we ask are:

• When exactly was your COVID-19 infection and how severe was the course (with/without fever, hospitalization)?
• What symptoms did you have during the acute phase?
• Which complaints are now in the foreground and when do they occur?
• How has your physical resilience changed compared to before the infection?
• Do you have any pre-existing heart conditions?

Good preparation on your part is very helpful here. Keeping a symptom diary for a few days can give us valuable information.

Template for a symptom diary

The diagnostic tools of the cardiologist after COVID

Based on the consultation, we initiate a step-by-step and targeted diagnosis. The aim is to check the most frequent and most important cardiac causes of your symptoms.

• Physical examination: Including blood pressure measurement while lying and standing to assess circulatory reactions.
• Resting ECG: To analyze the heart rhythm and look for signs of inflammation or damage.
• Laboratory examination: We determine important blood values, in particular cardiac troponin (a marker for heart muscle damage), inflammation values and coagulation parameters.
• Cardiac ultrasound (echocardiography): This is a key examination to assess the pumping function, the heart valves and the structure of the heart muscle in detail.
• Further diagnostics: Depending on the findings, a long-term ECG (for heart palpitations), an exercise ECG (to objectively measure the reduction in performance) or a long-term blood pressure measurement may be useful.

Typical findings and what they mean: From myocarditis to POTS

The investigation by the Cardiologists after COVID can lead to various diagnoses. The most common include

• Inflammation of the heart muscle (myocarditis): An inflammation of the heart muscle that requires consistent physical rest.
• Inflammation of the pericardium (pericarditis): Inflammation of the pericardium, often associated with chest pain.
• Postural tachycardia syndrome (POTS): A dysregulation of the circulation that leads to an excessive increase in heart rate when standing. This is a common cause of palpitations and dizziness after COVID-19.
• Inadequate sinus tachycardia: A persistently elevated resting heart rate without a recognizable structural cause, caused by a disorder of the autonomic nervous system.
• Inconspicuous organic findings: Very often we also find no structural damage to the heart. This is very reassuring news, even if the symptoms persist. The cause then often lies in a general deconditioning or dysregulation of the nervous system, which takes time to heal.

The cardiologist after COVID

One of the most important questions for active people is: „When can I do sport again?“. Exercising too early or too intensively after a COVID-19 infection carries considerable risks. As a sports cardiologist, Dr. Raphael Bruno is your expert for the „return to sport“ decision. Based on the course of your illness and the results of the cardiology examination, we will create a safe and step-by-step plan for your return to full athletic capacity. The most important rule is: start slowly and listen to your body's signals.

Frequently asked questions to the cardiologist after COVID

Here we answer common questions we are asked by patients after a corona infection.

I have been vaccinated. Can I still get heart problems after an infection?

Yes, the vaccination protects against severe courses of COVID-19, but it does not prevent 100% infection. Post-COVID symptoms, including heart problems, can also occur in vaccinated people after a breakthrough infection, although the risk appears to be lower.

How long can such post-COVID heart symptoms last?

The duration is very individual. For many patients, symptoms improve slowly and gradually over a period of three to six months. For some, however, the symptoms can persist for 12 months or longer. Patience and symptom-adapted management are crucial here.

My family doctor can't find anything. Should I still see a cardiologist after COVID?

Yes, if you continue to suffer from specific cardiovascular symptoms, it is advisable to see a specialist. A Cardiologist after COVID has specific diagnostic capabilities (e.g. cardiac ultrasound, stress tests) and the expertise to detect even subtle dysfunctions that may not be apparent in a basic examination.

Can post-COVID heart disease be treated?

Yes, the treatment depends on the diagnosis. Myocarditis is primarily treated with consistent physical rest. Circulatory training and increased fluid intake help with POTS. Low-dose medication such as beta blockers can alleviate the symptoms of palpitations.

Is the risk of heart problems lower with the newer virus variants?

On average, the newer Omikron variants lead to milder acute courses of the disease. However, post-COVID syndromes, including heart problems, can still occur. Any SARS-CoV-2 infection poses a potential risk of long-term consequences, so caution is advised.

I am afraid of vaccination because of the risk of myocarditis. What is the greater risk?

The scientific data here is clear: the risk of suffering myocarditis from COVID-19 disease itself is many times higher than the very rare risk of vaccine-associated myocarditis. A Cardiologist will give you a post-COVID-infections than after vaccination.

Does age play a role in the risk of post-COVID heart problems?

Post-COVID syndromes can occur at any age. While severe acute courses are more common in older patients, younger to middle-aged patients, especially women, appear to be more frequently affected by functional disorders such as POTS in the context of long-COVID.

What can I do myself to support my heart's recovery?

The most important thing is to listen to your body and not overtax it („pacing“). A healthy, anti-inflammatory diet, sufficient sleep and gentle exercise in pain-free and symptom-free areas (e.g. walks) are the best measures to support regeneration.

I'm still so tired after corona. Is that my heart?

Pronounced fatigue is a core symptom of post-COVID syndrome. It may or may not have a cardiac cause. An examination at the Cardiologists after COVID is important to rule out heart failure as the cause. However, there is often an independent neuro-immunological disorder.

Are my complaints taken seriously?

Yes, absolutely. We know how distressing and unsettling the symptoms following a COVID-19 infection can be. At our practice, you can be sure that we will listen carefully to what you have to say and take all the necessary steps to find or rule out an organic cause for your symptoms.

Your path to recovery - We create clarity for your heart

Persistent symptoms after a COVID-19 infection are not imaginary. A specialized cardiological examination can help you understand the causes, rule out serious illnesses and find a safe way back to an active and carefree life. If you are suffering from heart or circulatory problems after corona, make an appointment. We are here for you.