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

If you experience new or persistent symptoms related to your heart, circulatory system, or overall stamina following a COVID-19 infection or other serious infections, a cardiologist is the right person to consult. Many people do not feel fully recovered even long after the acute infection has subsided. Persistent heart palpitations, shortness of breath, or a noticeable decline in physical performance can be very alarming. At our practice, we take these post-COVID symptoms very seriously and offer you a structured evaluation by our experienced cardiologist, Dr. Raphael Bruno, to identify 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 irregular heartbeats), a stress ECG (to measure cardiac function), or long-term blood pressure monitoring may be recommended.

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 is often general physical deconditioning or a dysregulation of the nervous system, which may require time to recover.

The cardiologist after COVID

One of the most important questions for active people is: „When can I start exercising again?“ Exercising too soon or too intensely after a COVID-19 infection carries significant risks. For questions regarding sports cardiology, Dr. Raphael Bruno is your point of contact when deciding on your „return to sport.“ Based on the course of your illness and the results of your cardiological examination, we’ll develop a safe, 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 experience specific heart or circulatory symptoms, it would be a good idea to see a cardiologist. 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 push it too hard („pacing“). A healthy, anti-inflammatory diet, adequate sleep, and gentle exercise that does not cause pain or symptoms (e.g., walks) are effective ways to support recovery.

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

Severe fatigue is a core symptom of post-COVID syndrome. It may, but does not necessarily, have a cardiac cause. A follow-up evaluation by a cardiologist after COVID is important to identify heart failure as a cause or to rule it out. However, it is often a distinct neuroimmunological 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, we listen carefully to your description of your symptoms and take the necessary steps to identify an organic cause for your symptoms or to rule it out.

Your path to recovery - We create clarity for your heart

Persistent symptoms following a COVID-19 infection are not all in your head. A cardiology evaluation