Heart troubles

by Larisa Hockey – Last updated:

Prior to getting Long Covid in my mid-40s,  life was full. I homeschooled my kids, rode my horse, hiked around our farm, walked on the beach, went to church, and spent time with friends and family. Since contracting ME/CFS from Long Covid, I spend most of my time resting and cannot do the things I love.

My initial Covid-19 infection was mild and I recovered completely. However, a few weeks after my quarantine finished I developed intense fatigue, crippling headaches, anxiety and nausea. My heart rate would shoot up by just standing, and often I would hear my heart pounding in my ears when I was trying to sleep.  These symptoms were so bad they rendered me bed-bound for months on end.

It has now been two years and a half years and while I am better than those initial months, I still am very limited in what I can do.

A brief explanation of heart issues

Research has shown that, following a Covid-19 infection, people are at an increased risk of heart attack. So if you suffer from chest pain and shortness of breath, please get this checked out. Call 111 or go to your Emergency Department immediately.

People with Long Covid often report having chest pain and irregular heart beats. It is always important to see your doctor about any changes in your heart. Sometimes tests cannot find a reason for the pain and breathlessness associated with Long Covid, but it is always important to get checked.

Common symptoms include:

  • Tachycardia (increased heart rate)
  • Arrhythmia (heart rhythm changes)
  • Chest pain – sometimes this turns out to be costochondritis, pain due to an inflammation between the ribs.

Following a Covid-19 infection, people are at increased risk of heart diseases, including:

  • heart failure (when the heart doesn’t pump as well as it should)
  • pericarditis (an inflammation of the lining of the tissue surrounding the heart)
  • myocarditis (inflammation of the heart muscle)
  • blood clots in the lungs; and 
  • POTS/dysautonomia. POTS is present in a large proportion of those with Long Covid. 

If you are diagnosed with any of these issues your cardiologist (heart specialist) will monitor you and may provide medication.

Unfortunately sometimes the clinically available tests do not show any specific causes for heart pain or irregular heartbeats. While it can be comforting to know there is no serious damage, it can be very disconcerting to know that something is wrong, but there is no explanation.  More research is needed in this area.

A high heart rate can also be caused by a dysregulation of the nervous system, which Covid can cause.
Sometimes doctors may confuse a dysregulated nervous system with anxiety.  If you are diagnosed with anxiety but you believe that there is more going on with your heart, please seek another opinion. 

Long Covid Support Aotearoa

For more information

The New Zealand Heart Foundation has a helpful article on Long Covid and the heart.

In my experience

Every time I stood up my heart would start beating faster.  It would get up to 120 beats per minute just by standing or having a shower. 

I was diagnosed with mild POTS, which explained this effect, and over time it has improved. 

My heart still starts beating a lot more if I walk more than 50 metres, or go up stairs, so I always stop and rest to give it a chance to calm down. 

If I drink any alcohol my heart pounds very loudly as I try to go to sleep, so I can’t have a glass of wine.

What others say about their heart issues feels like

I have chest pain that comes and goes and palpitations.  My GP did an ECG which was normal and I was sent away with nothing more.  I know there is something going on but was told it is lung wall inflammation.  Gina 43

The main issue is tachycardia (rapid heart rate) if I walk up a hill or overdo any physical exercise. I have to creep along slowly to keep my heart rate down.   Mahala 45

I was diagnosed with Covid induced pericarditis. My heart rate reaches 180 beats per minute with any physical activity, and sometimes at resting as well, but ECGs have been normal.  My GP has tried many medications but none will lower my heart rate yet!   Lauren 36

I had tachycardia, chest pain and pressure for just over a year.  Initially I couldn’t stand up because my heart rate was so high I got horribly dizzy.  I could feel my heart in my neck which was very scary and unpleasant.  After 9 months I was checked out and everything was structurally fine but I was put on beta blockers, which I stopped when the symptoms weren’t so severe.  Anna   35

If I push myself even a little, my heart starts pounding, I can feel it and even hear it. It’s quite scary.  My GP is booking me in for an assessment where they will put me on a treadmill.  It takes all my effort just to walk around so I’m not sure of the treadmill thing.   John 43

I have continuous heart palpitations and tachycardia along with POTS symptoms. Every test I have had has come back normal, however it’s obvious that this is not normal.    Sarah  20

I have chest pain on mental or physical exertion and palpitations while resting. It was worse when I was still trying to participate in work, life events etc.  Now I lead a very small life and the pain has lessened.    Kay 55

My ECG was normal so I have had no tests. I blacked out a handful of times when standing up so I would stay in bed when my resting heart rate got too high.  It would get to 140 bpm just walking to the kitchen.   Troy  28

I have frequent episodes of palpitations and fast heart rate, but nothing shows up on an ECG. Recently a mouthful of cider set it off.  My heart really disapproves of alcohol!   Ellen, 43

I have had ongoing tachycardia and also have POTS symptoms.  Heavy lifting is a no-go and I can’t walk far. I recently carried a moderately heavy box and my heart rate shot up to a range my smart watch categorised as “intensive exercise.”  Zara 37

What I have tried

I used a smart watch to monitor my heart rate and I would stop activities if it got too high. 

I used a calculation that ME/CFS patients use to keep the heart rate at below 60 percent of my maximum, to avoid it being too high.  This is a great article which explains why it can help to keep the heart rate below 60%.   

I drank electrolytes to increase my blood volume which can help with POTS symptoms.  

I also did breathing exercises and meditations to calm my heart rate when it went too fast due to my nervous system getting dysregulated.

Over time, as my overall health improved, my heart issues have improved. 

What others have tried

  • Staying within “energy envelope”
  • Rest and allowing the body to recover.
  • Heart rate monitors to better manage exertion.
  • Hydration
  • Electrolytes
  • Reducing or eliminating sugar and alcohol
  • Medicinal cannabis
  • Cold packs on the back of the neck or a cold shower
  • Medications such as beta blockers
  • Compression wear

“For the “normal” level palpitations I find electrolytes help.  I tried so many things – breathing exercises, singing, meditation – but unfortunately I think that time was the only true fix.”  Ellen.



The best advice I received

Always check out heart issues and call an ambulance if something changes significantly.  But after being checked, try not to worry about strange sensations, particularly if you have to wait a while for specialist appointments, as worry can make it worse.

How others can help

Heart issues can be distressing, so having someone to talk to can help.  

Ask a family member to take you to the doctor or call an ambulance if you are feeling very unwell.

If you would like to connect with others who are experiencing similar symptoms you can join our support group.

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