In some cases, COVID-19 leads to pericarditis, which is inflammation of the sack-like membrane containing the heart. COVID-19 can also cause myocarditis, which is inflammation of the heart muscle.

Both pericarditis and myocarditis are rare overall, but the number of cases began to increase during the COVID-19 pandemic. Sometimes, both conditions occur at the same time. This is known as myopericarditis.

Researchers are still trying to understand why COVID-19 can result in this complication. However, prompt treatment with rest and medications to reduce inflammation can lead to a full recovery.

This article explores heart inflammation after COVID-19, including the symptoms and treatment options.

An older woman in hospital undergoing a physical examination from a doctor due to heart inflammation after COVID-19.Share on Pinterest
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Yes, COVID-19 has links to heart inflammation, specifically to pericarditis and myocarditis.

The Centers for Disease Control and Prevention (CDC) report that, between March 2020 and January 2021, myocarditis occurred in 150 per 100,000 people who spent time in hospital with COVID-19 compared with 9 per 100,000 people without COVID-19.

A 2022 study found that among 159 people people who spent time in hospital with COVID-19, 1 in 8 had myocarditis 28–60 days later. The risk was significantly higher in severely ill individuals who required a ventilator or intensive care support. The majority of the study participants had not had vaccinations.

Not all studies have found that myocarditis is this common, though. A 2023 study in the United Kingdom found a rate of probable myocarditis of 6.7% in people who had hospital treatment for COVID-19, compared with 1.7% in people without COVID-19.

Potential link

The virus that causes COVID-19 may attack cells in the heart directly, causing inflammation. The immune response to the virus could also cause inflammation.

As part of long COVID

Heart inflammation after COVID-19 may occur on its own or as part of a group of lingering symptoms that persist for weeks or months after the initial infection, known as long COVID.

Learn more about long COVID.

COVID-19 can cause or exacerbate various heart problems besides inflammation of the heart muscle and lining, including:

A 2023 study followed a group of more than 7,500 individuals who developed COVID-19 in 2020. The authors noted that these individuals were more likely to develop heart disease than people who never developed COVID-19 over the following 18 months.

Studies into the long-term effects of COVID-19 on heart health are still ongoing.

Myocarditis and pericarditis symptoms can resemble those of a heart attack.

People who experience chest pain and shortness of breath should seek immediate medical attention.

Is it a heart attack?

Heart attacks occur when there is a lack of blood supply to the heart. Symptoms include:

  • chest pain, pressure, or tightness
  • pain that may spread to arms, neck, jaw, or back
  • nausea and vomiting
  • sweaty or clammy skin
  • heartburn or indigestion
  • shortness of breath
  • coughing or wheezing
  • lightheadedness or dizziness
  • anxiety that can feel similar to a panic attack

If someone has these symptoms:

  1. Dial 911 or the number of the nearest emergency department.
  2. Stay with them until the emergency services arrive.

If a person stops breathing before emergency services arrive, perform manual chest compressions:

  1. Lock fingers together and place the base of hands in the center of the chest.
  2. Position shoulders over hands and lock elbows.
  3. Press hard and fast, at a rate of 100–120 compressions per minute, to a depth of 2 inches.
  4. Continue these movements until the person starts to breathe or move.
  5. If needed, swap over with someone else without pausing compressions.

Use an automated external defibrillator (AED) available in many public places:

  1. An AED provides a shock that may restart the heart.
  2. Follow the instructions on the defibrillator or listen to the guided instructions.
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The symptoms of myocarditis and pericarditis can vary from mild to life threatening.

Myocarditis symptoms

Symptoms of myocarditis can include:

Pericarditis symptoms

In pericarditis, the main symptom is chest pain, which is often severe.

The pain is typically behind the breastbone in the center of the chest but may radiate across the chest. Some people find that the pain is worse when they inhale and better when they lean forward.

Diagnosing heart inflammation after COVID-19 typically involves a combination of medical history assessment, physical examination, and diagnostic tests.

Healthcare professionals may:

  • Review a person’s medical history: The doctor may ask about their experience of COVID-19 infection and any cardiac symptoms.
  • Perform a physical examination: The doctor may assess vital signs, listen to the heart and lungs, and look for signs of fluid retention or inflammation.
  • Order blood tests: Blood tests can reveal markers of inflammation or cardiac injury, such as elevation in the C-reactive protein, cardiac troponins, and white blood cells.
  • Conduct electrocardiography: Electrocardiograms record the heart’s electrical activity and can identify irregularities or changes indicative of heart inflammation.
  • Perform medical imaging: Doctors may use echocardiograms or a cardiac MRI to assess the heart’s structure and function and check for the presence of pericardial effusion.

The treatment of myocarditis and pericarditis after COVID-19 may vary depending on the severity of the condition and other factors.

General treatment approaches include:

  • Rest: A person will need to rest and limit physical activity until a doctor says it is safe to begin exercising again. This may not be for 3–6 months.
  • Medications: Anti-inflammatory medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids, may help reduce inflammation and alleviate symptoms. Doctors may also use colchicine for pericarditis.
  • Limiting alcohol: It is best for people with myocarditis not to have more than one alcoholic drink per day. It is also best to take steps to support heart health, such as stopping smoking or monitoring salt intake, if applicable.
  • Managing complications: Additional medications or procedures may be necessary if complications such as an irregular heart rhythm or a fluid buildup occur. In severe cases, a person may require a stay in hospital for treatment.

Close monitoring by a healthcare professional is essential to track a person’s progress and adjust treatment as necessary.

The outlook for most people with myocarditis or pericarditis is favorable.

Most people who develop pericarditis make a complete recovery, and those with myocarditis also usually have a good outlook.

However, the recovery process takes time and may last several months. During this time, it is important that people:

  • get plenty of rest
  • avoid things that make symptoms worse
  • avoid exercise until a doctor says it is okay

After treatment, people will need to attend regular follow-up visits to ensure their condition is improving. They will also need to continue taking any medications as prescribed.

Occasionally, myocarditis and pericarditis have a delayed onset. Depending on the cause, the conditions can come back again in the future. It is currently unclear whether COVID-19 can cause this.

People will need to contact a doctor if any symptoms return.

COVID-19 can cause heart inflammation, such as myocarditis or pericarditis. These conditions are rare overall but more common in those who have had COVID-19 than those who have not.

Myocarditis and pericarditis can cause chest pain, shortness of breath, fatigue, and weakness. These symptoms can also be similar to those of a heart attack. If a person is in any doubt about their condition, it is important to seek medical advice right away to determine whether they are experiencing a medical emergency.

Treatment strategies include rest, anti-inflammatory medications, and pain relief. Recovery can take time, but most people will make a full recovery.