Heart conditions and the link to Coronavirus (COVID-19)

Most people with coronavirus (Covid-19) have mild symptoms and make a full recovery. 

It is thought that having a heart and circulatory condition probably doesn’t make you any more likely to catch coronavirus than anyone else, but it may mean that you could get more ill if you catch it – which is why it’s really important to protect yourself.

We spoke to the British Heart Foundation, to gain clarification risks and how to stay protected.

Am I in the “clinically extremely vulnerable” group who need to stay at home for 12 weeks?

Some heart patients are considered at extremely high risk of severe illness from coronavirus. You are classed as clinically extremely vulnerable (at highest risk) if:

1. This would be if you have had a transplant at any time, including a heart transplant.
2. If are pregnant and you also have significant heart disease – defined by experts as any of the following:
   • Coronary heart disease (if you have symptoms)
   • Hypertrophic cardiomyopathy (if it affects your heart function)
   • Thickening of the heart muscle (left ventricular hypertrophy) caused by high blood pressure, pulmonary arterial hypertension, a narrowed or leaking heart valve if this is moderate or severe, heart failure that affects your left ventricular function.
   • Significant congenital heart disease.

How do I know if I need to abide by shielding rules?

• If you have received a letter or been contacted by your GP to say that you are considered extremely high risk, you need to do shielding in order to protect yourself.
  
• This means you must stay at home for 12 weeks from the day you were contacted.

If you are in one of these groups, you should protect yourself by staying at home, and minimising contact with people you live with, for the next 12 weeks. This is called shielding. If this applies to you, you will be contacted directly by the NHS with further advice.

If you think you fall into one of these categories but have not received a letter, email or text by now, you should discuss your concerns with your GP or specialist doctor or nurse.

I don’t fall into one of those groups: am I still at high risk from coronavirus?

Even if you are not at highest risk, you may still be at particularly high risk because of your heart condition if: 

• You have heart disease and you’re over 70
• You have heart disease and lung disease or chronic kidney disease
• You have angina that restricts your daily life or means you have to use your GTN frequently
• Heart failure, especially if it restricts your daily life or you’ve been admitted to hospital to treat your heart failure in the past year
• Heart valve disease that is severe and associated with symptoms (such as if you regularly feel breathless, or you have symptoms from your heart valve problem despite medication, or if you are waiting for valve surgery). A heart murmur that does not cause you symptoms doesn’t put you at high risk. 
• You’re recovering from recent open-heart surgery in the last three months (including heart bypass surgery)
• Cardiomyopathy (any type) if you have symptoms such as breathlessness, or it limits your daily life, or you’ve been told you have problems with your heart function 
• Congenital heart disease (any type) if you also have any of the following: lung disease, pulmonary hypertension, heart failure, you’re over 70, you are pregnant, or if you have complex congenital heart disease (such as Fontan, single ventricle or cyanosis). Read our information about coronavirus if you have congenital heart disease.

If you are in one of these groups, the advice is the same as for everyone in the UK (except for the clinically extremely vulnerable, who have to be even more careful to protect themselves): stay at home apart from essential needs.

If you don’t fall into one of the groups above, having a heart condition or any of these issues means you are at high risk – again, you should stay at home, apart from essential needs:

• Coronary heart disease, such as a past heart attack, stent, or bypass surgery (at any time)
• Over 70 years old
• High blood pressure (hypertension)
• Pregnancy
• Diabetes
• Lung disease, including asthma 
• Chronic kidney disease 
• Stroke
• Vascular dementia or small vessel disease in the brain
• Body mass index of 40 or over (severely obese)
• Smoking – because the act of smoking (putting your hand to your mouth) increases risk of catching it, and because it damages your lung health. If you smoke, stop today.

I have atrial fibrillation – am I at risk from coronavirus?

If you have atrial fibrillation, there isn’t enough information at the moment to tell whether it or other abnormal heart rhythm problems put you at higher risk from coronavirus. It seems likely if you have well controlled atrial fibrillation, that your risk is lower than for the groups mentioned above.

I have a pacemaker – am I at risk from coronavirus?

If you have a pacemaker, whether or not this raises your risk from complications will depend on the reason why your pacemaker was implanted. There is no evidence that the virus itself infects pacemakers or ICDs, or that it causes endocarditis.

I have high blood pressure – am I at risk from coronavirus?

High blood pressure (hypertension) is associated with increased death rates in people who have Covid-19 infection. This is based on data from large Covid-19 research studies which report population-level figures. So, it’s not easy to apply that directly to your individual level of risk.

The statistics that we have are not able to tell us whether there’s a difference in Covid-19 complications between people who have controlled or uncontrolled high blood pressure. But it may be that if you have well controlled blood pressure (in other words, your blood pressure has been brought down by medication to your target level), and you have not had complications caused by high blood pressure (such as thickening of your heart muscle), then your increase in risk is relatively small.

Need to ask a question?

If you have a heart or circulatory condition, or you care for someone who does, and would like to speak to someone about the Covid-19 coronavirus, you can call the Heart Helpline on 0300 330 3300, or email hearthelpline@bhf.org.uk.

You can find more information about looking after your heart and Coronavirus at: https://www.bhf.org.uk/informationsupport/coronavirus-and-you