ACC Publishes Guidance on Managing Cardiovascular Ailments Post-COVID Infection

By Jonathan Springston, Editor, Relias Media

The American College of Cardiology (ACC) this week published clinical guidance to help cardiologists treat problems such as myocarditis and other ailments associated with a COVID-19 infection.

“The best means to diagnose and treat myocarditis and long COVID following SARS-CoV-2 infection continues to evolve,” Ty Gluckman, MD, MHA, co-chair of the ACC expert consensus decision pathway that authored the guidance, said in a statement. “This document attempts to provide key recommendations for how to evaluate and manage adults with these conditions, including guidance for safe return to play for both competitive and non-competitive athletes.”

Myocarditis (heart inflammation) has been reported among children and adults after SARS-CoV-2 infection as well as after receiving an mRNA vaccine. If myocarditis is present, patients might complain of shortness of breath, chest pain, or palpitations. Cardiologists might be suspicious if they see abnormal findings on ECG or cardiac troponin tests in patients who have been infected with COVID. The ACC calls for hospitalizing these patients with mild or moderate symptoms to continue monitoring, re-testing, and treatment.

Long COVID has become the catch-all term applied to the formal "post-acute sequelae of SARS-CoV-2 infection." Generally, long COVID applies to persistent health problems that last four or more weeks after a SARS-CoV-2 infection. For cardiology specifically, these conditions include heart palpitations, shortness of breath, exercise intolerance, chest pain, and dyspnea on exertion.

“There appears to be a ‘downward spiral’ for long COVID patients. Fatigue and decreased exercise capacity lead to diminished activity and bedrest, in turn leading to worsening symptoms and decreased quality of life,” Nicole Bhave, MD, co-chair of the ACC expert consensus decision pathway, said. “The writing committee recommends a basic cardiopulmonary evaluation performed up front to determine if further specialty care and formalized medical therapy is needed for these patients.”

For more on this and related subjects, be sure to read the latest issues of Clinical Cardiology Alert, Hospital Infection Control & Prevention, and Infectious Disease Alert.