MB INVESTIGATIVE SERIES: HEART HEALTH CONT. —>COVID'S HIDDEN HEART DAMAGE: WHAT I SAW WORKING IN GENERAL CARDIOLOGY DURING COVID (& WHAT THEY'RE NOT TELLING YOU)
A Personal Account from the Front Lines
FROM THE FOUNDER: WHAT I WITNESSED
In 2021 I was working for one of New York's most prestigious hospitals in cardiology and I started seeing a pattern.
Young people—healthy, active, athletic—coming into cardiology clinics with complaints that didn't make sense for their age or fitness level:
Shortness of breath (SOB). Athletes who used to run marathons couldn't climb a flight of stairs without gasping.
Heart palpitations. College students feeling their hearts race, skip beats, or flutter for no apparent reason.
Chest pain. Personal trainers, yoga instructors, dancers—all describing pressure, tightness, or sharp pains in their chests.
Extreme fatigue. People in their 20s and 30s sleeping 12+ hours a day and still exhausted.
At first, doctors were puzzled. These were not the typical cardiac patients. No family history. No smoking. No diabetes. No obesity.
But then I noticed the common denominator:
Every single one of them had recently had COVID-19.
Some had been hospitalized. Most had not. Many described their cases as "mild"—a bad cold, a week of fever, loss of taste and smell.
But their hearts told a different story.
THE PATTERN I COULDN'T IGNORE
I started tracking the cases informally—just keeping mental notes as patients cycled through our cardiology department.
Here's what I saw:
Patient 1: 24-year-old male, division I soccer player. Had COVID in March 2021 (mild case, recovered at home). Six months later, couldn't finish a practice without chest tightness and dizziness. Diagnosis: Myocarditis (heart inflammation).
Patient 2: 32-year-old female, marathon runner. Had COVID in August 2021 (moderate case, never hospitalized). Started having heart palpitations and shortness of breath in October. Diagnosis: Postural Orthostatic Tachycardia Syndrome (POTS)—her heart rate would spike to 140+ just from standing up.
Patient 3: 19-year-old male, college basketball player. Had COVID in December 2020 (asymptomatic—only knew because of team testing). One year later, collapsed during a game. Diagnosis: Cardiac MRI showed heart scarring consistent with previous myocarditis that had gone undetected.
Patient 4: 28-year-old female, personal trainer. Had COVID in April 2021. By summer, she couldn't teach her fitness classes anymore. Heart rate would spike to 160 during light exercise. Multiple ER visits. Dismissed as "anxiety" until we finally did a full cardiac workup. Diagnosis: Post-COVID dysautonomia and exercise intolerance.
The common thread? COVID.
And yet, when I'd ask these patients if their primary care doctors had connected their symptoms to COVID, most said: "No. They told me it was anxiety. Or deconditioning. Or stress."
WHAT THE RESEARCH SHOWS (AND WHAT THEY'RE NOT PUBLICIZING)
I wasn't imagining this pattern. The science backs it up.
1. Nature Medicine (2023): "Long-term Cardiovascular Outcomes of COVID-19"
This landmark study followed 153,760 COVID survivors for 12 months post-infection.
Key findings:
COVID survivors had a 72% increased risk of heart failure compared to people who never had COVID
63% increased risk of heart attack
52% increased risk of stroke
45% increased risk of arrhythmias
These risks were elevated even in people who had mild COVID and were never hospitalized
Translation: You don't have to have been on a ventilator for COVID to damage your heart. Mild COVID can still cause significant cardiac complications.
2. JAMA Cardiology (2024): "Myocarditis Following COVID-19 Infection in Young Adults"
Study of 5,000 young adults (ages 18-35) post-COVID:
2.3% developed myocarditis (heart muscle inflammation)
Many cases were subclinical (no symptoms, or symptoms mistaken for other things)
Cardiac MRI revealed heart scarring even in asymptomatic cases
Translation: Even if you felt fine during and after COVID, your heart may have been damaged. And you might not know until years later.
3. The Lancet (2025): "Post-COVID Cardiovascular Syndrome in Adolescents and Young Adults"
Study of 10,000 people ages 12-25 post-COVID:
1 in 8 (12.5%) reported new-onset heart palpitations, chest pain, or shortness of breath within 6 months of infection
40% had abnormal findings on echocardiograms (heart ultrasounds)
Black and Hispanic teens were twice as likely to have persistent symptoms but less likely to receive follow-up cardiac testing (medical racism strikes again)
Translation: Young people are not immune. COVID is causing widespread, often undiagnosed cardiac damage in teens and young adults.
4. Circulation (2024): "Sudden Cardiac Arrest Risk in Young COVID Survivors"
This study found that young COVID survivors (ages 18-40) had a 5x increased risk of sudden cardiac arrestcompared to peers who never had COVID.
Five times.
Let that sink in.
Previously healthy young people are at significantly elevated risk of dying suddenly from cardiac arrest after COVID.
WHY AREN'T DOCTORS TELLING PATIENTS THIS?
Great question. Here's why:
1. They don't want to "create panic."
Public health officials and hospital administrators feared that if people knew COVID could cause long-term heart damage, it would:
Overwhelm cardiology clinics
Cause mass anxiety
Make people afraid to return to normal life
So instead of informing people, they downplayed it.
2. Insurance companies don't want to pay for cardiac testing.
An echocardiogram costs $500-2,000. A cardiac MRI costs $1,000-5,000. A Holter monitor costs $200-800.
If millions of COVID survivors needed these tests, insurance companies would lose billions.
So they instructed doctors to be "conservative" in ordering tests.
Translation: Only order tests if symptoms are severe. Otherwise, dismiss as anxiety.
3. The medical establishment didn't take long COVID seriously.
For the first two years of the pandemic, long COVID patients—disproportionately women, disproportionately people of color—were told their symptoms were:
Psychosomatic ("It's in your head")
Anxiety or depression
Deconditioning ("You just need to exercise more")
Doctors gaslit millions of patients.
And many are still doing it.
WHAT COVID DOES TO THE HEART: THE SCIENCE
COVID-19 is not just a respiratory virus. It's a vascular disease—meaning it attacks blood vessels throughout the body, including those in and around the heart.
Here's how:
1. Direct Viral Invasion
SARS-CoV-2 (the virus that causes COVID) binds to ACE2 receptors, which are abundant in:
Lungs
Blood vessels
Heart muscle (myocardium)
Pericardium (sac around the heart)
When the virus enters heart cells, it:
Causes inflammation (myocarditis)
Damages heart muscle cells
Disrupts electrical signaling (leading to arrhythmias)
2. Hyperinflammation and "Cytokine Storm"
COVID triggers an exaggerated immune response called a cytokine storm, where the body releases massive amounts of inflammatory molecules.
This inflammation:
Damages blood vessel linings (endothelium)
Increases blood clotting risk (leading to heart attacks and strokes)
Causes fluid buildup around the heart (pericardial effusion)
Weakens the heart muscle
3. Microclots and Endothelial Damage
Research published in Cardiovascular Research (2024) shows that COVID causes persistent microclots (tiny blood clots) in blood vessels, including coronary arteries.
These microclots:
Reduce blood flow to the heart
Cause chest pain and shortness of breath
Increase risk of heart attack
Even months after "recovery," these microclots persist in some patients.
4. Autonomic Nervous System Dysfunction
COVID damages the autonomic nervous system (which controls heart rate, blood pressure, digestion, etc.).
This leads to conditions like:
POTS (Postural Orthostatic Tachycardia Syndrome) – heart rate spikes when standing
Inappropriate sinus tachycardia – resting heart rate of 100+ bpm for no reason
Exercise intolerance – inability to tolerate physical activity that was previously easy
THE SYMPTOMS THEY DISMISSED AS "ANXIETY"
Here are the symptoms I saw repeatedly in young, healthy COVID survivors—and that were almost always initially dismissed:
Heart palpitations:
Feeling like your heart is racing, fluttering, or skipping beats
Often worse at night, or triggered by standing up
Shortness of breath:
Difficulty breathing with minimal exertion
Feeling like you can't take a full breath
Worse when lying flat
Chest pain:
Sharp, stabbing pain (often pericarditis)
Pressure or tightness (often microclot-related reduced blood flow)
Pain that worsens with deep breathing or lying down
Fatigue:
Bone-deep exhaustion that doesn't improve with rest
Post-exertional malaise (worsening symptoms after activity)
Dizziness/Fainting:
Lightheadedness when standing (POTS)
Near-fainting episodes
Brain fog
Exercise intolerance:
Inability to perform physical activities you used to do easily
Heart rate spikes inappropriately during exercise
Prolonged recovery time after exertion
WHAT TO DO IF YOU HAD COVID AND HAVE THESE SYMPTOMS
Step 1: Trust Yourself
If you had COVID (even mild COVID) and you're experiencing cardiac symptoms, you are not crazy. You are not anxious. Something is wrong.
Step 2: Demand Testing
Go to your doctor and say:
"I had COVID [X months/years ago]. Since then, I've been experiencing [list symptoms]. Given the research on post-COVID cardiac complications, I would like the following tests:
1. Electrocardiogram (ECG) 2. Echocardiogram 3. Troponin blood test 4. BNP blood test (measures heart stress) 5. Holter monitor or event monitor (24-48 hours or longer)
If my symptoms persist, I'd like a referral to a cardiologist and potentially a cardiac MRI."
If your doctor dismisses you:
Say: "I understand you may think this is anxiety, but I'd like these tests to rule out cardiac causes. If you're not willing to order them, please document in my chart that I requested them and you declined. I'd like a copy of that documentation."
(Doctors HATE being asked to document refusal. It's a liability. Often, they'll order the tests rather than document refusal.)
Step 3: Find a Post-COVID Clinic
Many major medical centers now have Long COVID clinics or Post-COVID Care Centers.
These clinics specialize in post-COVID complications, including cardiac issues.
Examples:
Mount Sinai Center for Post-COVID Care (NYC)
Johns Hopkins Post-Acute COVID-19 Team (Baltimore)
UCSF Post-COVID Clinic (San Francisco)
UCLA Post-COVID Clinic (Los Angeles)
Step 4: Track Your Symptoms
Keep a detailed log:
Date and time of symptoms
What you were doing when symptoms occurred
Severity (1-10 scale)
Duration
This documentation is critical if you need to advocate for disability accommodations, insurance appeals, or medical leave.
THE VACCINE QUESTION: DOES THE COVID VACCINE ALSO CAUSE HEART DAMAGE?
Yes—but let's be very clear about the context.
Myocarditis (heart inflammation) can occur after COVID vaccination, particularly:
In young males (ages 12-29)
After the second dose of mRNA vaccines (Pfizer, Moderna)
Typically mild and resolves with rest
The numbers:
Vaccine-associated myocarditis: Approximately 12-13 cases per million doses in young males
COVID-associated myocarditis: Approximately 150 cases per million infections
Translation: You are about 10-12 times more likely to get myocarditis from COVID infection than from the vaccine.
Source: CDC, American Heart Association, JAMA Cardiology (2024)
But here's what they're NOT studying adequately:
Long-term effects of repeated mRNA vaccinations on cardiac health.
We have:
Billions of people vaccinated
Many people have received 4, 5, 6+ doses
Limited long-term data on repeated exposure
What we need:
Large-scale studies tracking cardiac outcomes in vaccinated individuals over 5-10 years
Studies comparing cardiac health in:
Unvaccinated/uninfected
Vaccinated/uninfected
Unvaccinated/infected
Vaccinated/infected
Why we don't have it:
Studies take time (it's only been 4-5 years since vaccines rolled out)
Political polarization makes objective research difficult
Funding challenges
MB's take: The vaccine prevents severe COVID, hospitalization, and death. That's undeniable.
But: We should be able to have honest conversations about potential side effects without being labeled "anti-vax."
Both can be true:
The vaccine saves lives
AND we need more long-term safety data
Science requires asking questions. Blind trust in pharmaceutical companies is not scientific—it's faith.
WHAT ABOUT LONG COVID AND "LONG VAX"?
Long COVID = Persistent symptoms (3+ months) after COVID infection
"Long Vax" = A term some use to describe persistent symptoms after vaccination (though this is not an officially recognized medical term)
What we know:
Long COVID affects an estimated 10-30% of people who had COVID (that's millions of people)
Symptoms include: fatigue, brain fog, shortness of breath, heart palpitations, POTS, exercise intolerance, and more
Some people report similar persistent symptoms after vaccination, but research is limited
What we need:
Research comparing symptom prevalence in:
Post-COVID (unvaccinated)
Post-vaccination (uninfected)
Post-COVID + vaccination
Better diagnostic tools for long COVID
Treatment protocols
Current treatment options:
Symptomatic management (beta-blockers for POTS, physical therapy, etc.)
Experimental treatments (anticoagulants, antivirals, immunomodulators)
No FDA-approved treatments for long COVID yet
THE RACIAL DISPARITY (BECAUSE OF COURSE THERE IS ONE)
According to a 2025 study in The Lancet:
Black and Hispanic COVID survivors are:
Twice as likely to experience persistent cardiac symptoms post-COVID
Less likely to receive cardiac testing (even when symptoms are identical to white patients)
More likely to have their symptoms dismissed as anxiety
Less likely to be referred to long COVID clinics
Why?
Same old story: medical racism.
Black patients are seen as:
Exaggerating symptoms
Drug-seeking
Non-compliant
"Anxious"
White patients with identical symptoms get echocardiograms. Black patients get told to relax.
MB'S TAKE: THEY FAILED US—AND THEY'RE STILL FAILING US
COVID revealed the cracks in our healthcare system.
They told us it was just a respiratory virus. It wasn't.
They told us young, healthy people would be fine. They weren't.
They told us long COVID was rare. It's not.
They told us vaccines had no risks. They do (though benefits far outweigh risks for most people).
And now, millions of people are living with heart damage—and most don't even know it.
WHAT NEEDS TO HAPPEN
1. Mandatory cardiac screening for all COVID survivors with symptoms
If you had COVID and have cardiac symptoms, you should get:
ECG
Echocardiogram
Troponin test
Insurance should cover it—no questions asked
2. Long-term studies on COVID and vaccine cardiac effects
We need 10-year follow-up studies tracking:
Heart health in COVID survivors
Heart health in vaccinated individuals
Comparative outcomes
3. Public education campaigns
People need to know:
COVID can damage hearts
Symptoms to watch for
When to seek care
That their symptoms are real and not "anxiety"
4. Treatment research for long COVID
We need FDA-approved treatments, not just symptomatic management.
5. Medical training on post-COVID complications
Doctors need to stop dismissing patients and start recognizing post-COVID cardiac damage.
IF YOU TAKE NOTHING ELSE FROM THIS ARTICLE, TAKE THIS:
If you had COVID—even mild COVID—and you're not feeling right:
Trust yourself. Demand testing. Find a doctor who listens. Document everything.
Your symptoms are real. Your heart matters. You deserve care.
And if the system won't give it to you, advocate like hell until you get it.
We are not a brand, but a blueprint.
And the blueprint says: Don't let them gaslight you. Your life depends on it.
SOURCES:
Nature Medicine, "Long-term Cardiovascular Outcomes of COVID-19" (2023)
JAMA Cardiology, "Myocarditis Following COVID-19 Infection in Young Adults" (2024)
The Lancet, "Post-COVID Cardiovascular Syndrome in Adolescents and Young Adults" (2025)
Circulation, "Sudden Cardiac Arrest Risk in Young COVID Survivors" (2024)
Cardiovascular Research, "Persistent Microclots in Long COVID" (2024)
Centers for Disease Control and Prevention (CDC), COVID-19 vaccination data
American Heart Association, Post-COVID cardiac care guidelines
Author's firsthand observations at Weill Cornell Medicine (2021-2022)