68 | JUNE 24 • 2021 

HEALTH

A

s COVID receded and patients 
started to return in normal num-
bers to the Beaumont Ministrelli 
Women’s Heart Center, Pamela Marcovitz, 
M.D., a cardiologist and the center’s medical 
director, began to observe the pandemic’s 
impact on her patients. 
From a cardiac perspective, she found 
that some patients’ lifestyles improved 
during the lockdown. They had more free 
time and couldn’t eat in restaurants, so they 
began cooking with healthy ingre-
dients, which had a positive impact 
on their heart health.
“Restaurants tend to use a lot of 
salt. By eating at home their blood 
pressure was controlled better,
” 
Marcovitz says. “Sometimes they 
used the extra time to exercise 
more. So, they had better choles-
terol levels and blood pressure. 
Some lost weight — usually 5-10 
pounds but one woman lost 38.
”
But other patients responded 
differently — eating more restau-
rant carryouts and binge watching televi-
sion. These patients didn’t do as well, she 
reports.
Sindhu Koshy, M.D., a cardiologist affil-
iated with Henry Ford Health System, says 
that her female patients tended to fall into 
bad health habits during the pandemic.
“They were not exercising and were 
eating more junk food,
” she explains. “The 
pandemic took a higher toll on women 
because many had to supervise their chil-
dren doing virtual schoolwork, as well as 
do their own work and handle household 
chores. It took a toll on their mental health, 
so they didn’t feel they could do as much 
exercise.
”

POST-COVID HEART PATIENTS
Both Marcovitz and Koshy provided fol-
low-up care to their regular cardiac patients 
after recovery from the virus, as well as new 
patients who experienced first-time cardiac 
symptoms after COVID. 
“Many patients had complications 
[after having the coronavirus] including 
myocarditis, and some had reduced heart 
function,
” Marcovitz says. “Some have pro-
longed symptoms of fatigue and shortness 

of breath.
”
Koshy explains, 
“
Anecdotally, there seem 
to be more women expe-
riencing post-COVID 
fatigue and shortness of 
breath. Their brain fog 
and fatigue seem to last 
longer but most improve 
within three months.
“The younger patients — under 60 — 
tend to be the long haulers. Younger people 
who hadn’t been vaccinated yet were more 
likely to experience severe complications.
”
Sometimes it just takes time, Marcovitz 
says. “We use exercise to build tolerance. 
Patients need to hydrate while exercising 
and their heart rate and blood pressure 
must be monitored. Some people put off 
routine checks of their blood pressure and 
cholesterol because of the pandemic and 
may need medical or other intervention for 
coronary blockages.
” 
In addition, some patients cut back on 
cardiac rehabilitation out of concern for 
COVID transmission or because these out-
patient programs were temporarily halted. 
As an alternative to in-person rehabilitation, 
some patients were given exercises to do at 
home, including video instruction, she says.
Post-COVID patients have an increased 
risk of developing clots in their legs and 
lungs or having a stroke. This could be 
because they were immobilized during their 
bout with COVID, which can lead to clots, 
Marcovitz says, or because their lifestyle or 
work life became more sedentary during 
the pandemic. 

TREATING POTS
Both cardiologists have tested and treat-
ed for Postural Orthostatic Tachycardia 
Syndrome (POTS) — a condition which 
some patients developed after COVID. 
POTS is a condition which affects blood 
flow, causing rapid heart palpitations, faint-
ing and lightheadedness as well as chronic 
fatigue and brain fog. 
“POTS is a condition of the autonomic 
nervous system, not primarily a cardiac 
problem,
” Marcovitz says. “It can be very 
debilitating and last a long time. POTS 
affects mostly women between 13 and 50 
years of age. We are seeing more of it in the 
last year.
Any severe illness, surgery or extreme 
weight loss can trigger it, she explains. 
Symptoms can occur when individuals 
stand up after sitting or reclining, or among 
those who stand for a long time as part of 
their jobs.
Treatments include core and leg exercis-
es, increased intake of fluids and greater 
salt intake to lower adrenalin levels that 
control heart rate. Compression stockings 
or pantyhose can also help. She adds that 
some medications, including beta blockers, 
are available to treat it. “This is a common 
reason why people are coming to us now,
” 
notes Marcovitz. 
Koshy has treated more cardiac patients 
with POTS or POTS-like symptoms after 
COVID as well. Many are severely dehy-
drated. “People who exercise are more likely 
to notice it. COVID can affect any or every 
system in the body,
” she says. 

SHARI S. COHEN CONTRIBUTING WRITER

Some women deal with lingering 
ef
 ects on their heart.
After COVID

Dr. Pamela Marcovitz 
with a patient 

Dr. Sindhu 
Koshy

