Chest Pains in Patients with Long-COVID Syndrome

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What is the reason for Chest Pains in Patients with Long-COVID Syndrome?

What is the reason for Chest Pains in Patients with Long-COVID Syndrome?

Long-COVID Syndrome, refers to symptoms that persist or emerge after the acute phase of COVID-19 infection has resolved. Among these lingering symptoms, chest pains stand out as a particularly concerning and discomforting manifestation. COVID-19-induced endothelial dysfunction may play a pivotal role in the pathogenesis of long COVID chest pains. Endothelial cells line the inner surface of blood vessels, regulating vascular tone, inflammation, and coagulation. SARS-CoV-2 can directly infect endothelial cells, triggering an inflammatory response and disrupting vascular homeostasis. This endothelial dysfunction may promote the formation of microthrombi, impair coronary perfusion, and precipitate myocardial ischemia, culminating in angina-like chest pains.

According to a recent Spanish study, published as a Research Letter in JACC: Cardiovascular Interventions INOCA (Ischaemia with NonObstructive Coronary Arteries) is responsible for chest pains in a proportion of Long-COVID Syndrome patients.

The researchers studied 20 patients with suspected INOCA and chest pains, which occured after documented COVID-19 infection. The participants had a mean age of 56 and 30% were men.
Interestingly, the symptoms of chest pains appeared 31 days (median) after the COVID infection confirmation. In the end, 80% (16 participants) were diagnosed with INOCA. The patients were treated with different combinations of BBlockers, Ca channel blockers, Nitrates, statins, ACE/ARBs and healthy lifestyles recommendations. At a follow up of over 200 days, angina frequency and stability significantly improved.

Link to the article below:
https://www.jacc.org/doi/10.1016/j.jcin.2024.01.072

Dr Bart Olechowski, private consultant cardiologist, located in Winchester, Basingstoke and Farnham sees patients with chest pains and possible anginal symptoms every Wednesday, Thursday and Friday.

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Dr Bart, a private consultant cardiologist in Winchester, Basingstoke, Farnham and London.

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