by Fabrizio Tundo
There is most likely a correlation between the body’s immune response and the appearance of extrasystoles. Recommended exams
I am a 36 year old woman and my last electrocardiogram, dating back three months ago, indicated excellent cardiac health. I have never suffered from heart disease. I regularly exercise, I don’t smoke or drink and I follow a healthy diet. I am not subjected to psychological stress. I am not taking any medications, apart from cholecalciferol for vitamin D deficiency (prescribed by my general practitioner). Three weeks ago I had Covid (mild form: one day of fever and three of cold-like symptoms). Once the infection disappeared, I started to notice, especially while I was at rest and never while carrying out physical activity, an irregularity in my heartbeat, like a “dip in my heart” or a stronger beat every now and then. The symptom still persists. Should I worry? Carry out investigations?
Answered by Fabrizio Tundo, Department of Arrhythmology, Monzino Cardiology Centre, Milan (GO TO THE FORUM)
The symptoms you describe suggest the appearance of extrasystoles, i.e. premature and/or supernumerary heartbeats (extrasystole indicates the presence of an “extra systole”, i.e. an extra cardiac contraction) which are typically felt as an alteration of the heartbeat described subjectively and variably by affected patients (“heart pounding”, “flickering”). Extrasystole in itself is not indicative of a cardiac pathology and may be a transient alteration of the heartbeat with no clinical relevance. In rarer cases, extrasystole can represent an alarm bell for a cardiac alteration and for this reason, especially if you practice sports, it could still be useful to carry out some basic tests. The fact that she is a young woman with a healthy lifestyle makes the latter situation quite unlikely.
Vaccine and infection
The appearance of transient extrasystole in the weeks following vaccination or Covid infection (even paucisymptomatic, as in his case) is reported by many patients we see daily in the clinic. There is therefore very probably a correlation between the body’s immune response and the appearance of extrasystoles, rather than a direct correlation between the viral infection and the extrasystoles, being present, albeit with lower intensity, even after vaccination (which does not include inoculation of a virus but only of the viral RNA to produce the spike protein). Rarely following Covid (and more likely in males), forms of myocarditis have been observed, i.e. cardiac involvement due to infection or inflammation, sometimes responsible for extrasystoles.
Recommended exams
It is possible that, as we move away from the Covid infection over time, the extrasystoles progressively decrease spontaneously (sometimes within a few months). In the meantime, for greater safety, you could carry out first level tests including an echocardiogram (to evaluate the morphology and function of the heart and valve structures), a 24h Holter ECG (for the quantification and qualitative evaluation of the extrasystoles themselves), of an exercise test on the cycle ergometer (to evaluate the behavior under exertion of extrasystoles with a view to resuming physical activity, even if its subjective sensation is already indicative of regression during exercise), in addition to routine blood tests and evaluation of thyroid function. Once the results of the above tests have been obtained, I would perform an outpatient cardiology visit with ECG for a final evaluation.
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January 19, 2024 (changed January 19, 2024 | 07:44)
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