“Can you get heart arrhythmia from the COVID infection?”

The more I learn about covid the less I know ! The best answer I can tell you is that covid can do anything to anyone at anytime.. sounds like a cop out but Im being honest , mostly. I should have said covid can do anything bad to anyone. No good comes from it. I had two patients get arrhythmias from covid vaccination, that stand out because of the complications. Both had atrial fibrillation and thromboembolic complications. Covid is an endothelial/ interstitial disease, infecting and inflaming the inner lining of blood vessels and organ tissues. Take the lungs, the virus attacks the lining in the small capillaries and arterioles where air crosses into the blood. Thats how oxygen gets from the air we breath and attached to the iron on the hemoglobin molecule on our red blood cells. That thin membrane of interstitial tissue becomes inflamed and leaky and causes the alveoli (air sacs) to become secondarily filled with fluid so their is little air exchange. The result is clinical pneumonia with low oxygen saturation (hypoxia ). This inflammatory state is hypercoaguable and blood clots form in the lungs and peripheral vascular circulation ,as in DVTs and pulmonary emboli. With the heart , covid can infect the lining ( endocardium) and the middle muscular layer ( myocardium) . This can lead to arrhythmias if the endocardium is affected in the electrical conduction system. The tissue inflammation can also cause myocarditis if the muscular myocardium becomes involved . .this can result in Atrial Fibrillation. A fib is the most common, but not the only arrhythmias noted to be the result of this process. Svt and other atrial tachycardia arrhythmias can occur. Sinus tachycardia (fast heart rate) is seen most commonly seen tach rhythm. Bradycardia, and slow rhythm like those of Heart block, and ventricular arrhythmias are less common. I have not personally seen a lot of primary cardiac manifestations of covid. In my clinic or in the hospital. Most of the hospital patients were for respiratory illnesses, including myself. I contracted pneumonia from covid in December of 2020. I had bilateral pneumonia with a pulmonary embolism that caused me to crash from a respiratory standpoint. Thankfully I was in good shape for my age, But I was still on oxygen for another month and missed 3 months of work - after 10 days in the icu ..I wasnt fully back to myself for almost a year . As for the 2 patients of mine that developed a-fib, both were after the maderna vaccine in 2021. They didnt actually get the virus. Pt A had a fib with a rate up to 170. Went into heart failure and had an embolus to his left foot. He had surgery and almost lost his leg. I did a trans esophagus echocardiogram and shocked him back into a regular rhythm. Sinus rhythm was maintained with anti arrhythmic meds. Angiogram confirmed no significant atherosclerosis of his coronaries..It took me a year to get him back to his normal baseline. But he was 63 yr old. Pt B was 25 years old. He got septic after the first dose of maderna and had high fever. After the second dose he had a fever of 105 and developed myocarditis , dilated cardiomyopathy with chf . and he secondary went into a fib from the dilated heart chambers. He developed a thrombus in the left ventricle at the apex ,or tip of the heart , that wasnt squeezing (mural thrombus). A part broke away and he a embolism to the vertebral arteries and a posterior cva (stroke) - involving the occipital lobe (part of the brain that has to do with vision). He lost peripheral vision in both eyes ( hemianopsia). I was able to convert him out of a fib with medication .. but he still has dilated weak heart and most likely has permanent peripheral blindness .. so with covid infection anything can happen. Myocarditis would be the most severe manifestation.. which could cause atrial fibrillation or even ventricular tachycardia. A fib and other arrhythmias can be caused directly by the virus and not be secondary to chf. Or even the older original version of the vaccines. The good news is like most viruses , covid has attenuated to the point where its no different than the flu, and no more virulent. I havent seen or heard of arrhythmias from covid in over a year. We have had very few respiratory failure patients or serious pneumonias. The atypical chest pain and shortness of breath that was prevalent ( due to dysautonomia) , has all but vanished ..