The flu and heart attack risks are connected: Get the vaccine, doctors say
If you get the flu, it’s not just the chills and body aches you have to worry about. For adults older than 35, the flu brings a substantial risk to your heart.
“We know that viruses can affect the heart,” said Dr. Juan-Carlos Brenes, a board-certified cardiologist and internist at Mount Sinai Medical Center in Miami Beach.
And this flu season is particularly virulent, with 97 children across the country dying from the flu as of Feb. 17, according to the Centers for Disease Control and Prevention.
“I’ve been in practice 31 years and I’ve never seen so many people this sick,” said Dr. Leonard Pianko, an Aventura cardiologist. “I had a perfectly healthy guy. I see him every six months and all he ever worried about was his tan. He came in rip-roaring sick” and was in ICU on intravenous medication.
“Because he was healthy, he got better,’’ he added. “But not everyone gets better.”
The CDC calls this year’s flu season the most intense since 2009’s swine flu pandemic when 710,000 people in the United States were hospitalized and 56,000 died.
A study in last month’s New England Journal of Medicine found the risk of having a heart attack within a week of catching the flu was six times higher than any other week. The Canadian study was based on all Ontario residents 35 and older who had tested positive for flu in a five-year period. In the study, 332 patients who tested positive for influenza had heart attacks during the five-year period, with the week after the flu’s onset being the riskiest.
Influenza can also cause myocarditis, an inflammation of the heart muscle.
Dr. David Lopez, a cardiologist with Cleveland Clinic Florida in Weston, has seen younger flu patients coming to the hospital with shortness of breath, maybe swelling of the legs and chest pain “because they have inflammation of the heart. They don’t have other risk factors and are not in the age group where you’d suspect heart disease. It can be very scary.”
“We may not see them now,” Lopez said of these patients under 40. “They come to see us in April and May when their flu is not getting better. That is when we diagnose heart failure.”
Brenes said flu can cause inflammation that affects the inner wall coating of the arteries.
“If you have plaque, the stress or swelling can dislodge the plaque, triggering a cascade of events that can end with a blocked artery. If the arteries get blocked slowly over the years, the heart can build in natural bridges that can compensate. But if plaque gets disrupted suddenly, then it can cause a heart attack,” Brenes said.
Reassuring a worried 38-year-old, Brenes told him that 74 percent of the Canadian heart attack victims were over 65. “Half were diabetic, 40 percent had high cholesterol and 85 percent had high blood pressure.”
“Even though the headline is ‘Having flu puts you at high risk for heart attack,’ ” Brenes thinks another headline should be, “Flu vaccination can actually prevent a heart attack.” Only 30 percent of the Canadian patients had been vaccinated, a lower rate than for Americans this year.
Two former heart patients who now believe in the flu shots are Bonnie Nelson, an Aventura investment banker, and Roslyn Sand, a retired nurse in Miami Beach.
Sand, who has had six bypasses, has taken the flu shot every year. Her new husband, Mauricio, didn’t believe in it.
As she tells it, “We got married on Sunday. Monday we got on the Norwegian Jade to go to Mexico and he gets the flu.”
Sand said Mauricio has seen five specialists in 10 days — a pulmonologist, an ear, nose and throat specialist, etc. “Today’s the first day he’s not coughing,” she said.
“I have five children and they have children and they all take the flu shot. My son-in-law, who’s a doctor, takes one, too,” Sand said.
Nelson wishes she had gotten the vaccine. She caught the flu in late October. “I was on blood pressure medicine and my blood pressure went out of control. I was coughing. I was getting nose bleeds. I couldn’t even stand up, and the flu was debilitating.
“I went to see Dr. Pianko every week for four or five weeks to make sure the blood pressure was OK and get the dizziness under control,” Nelson said.
The vaccine can help lower your risk of a heart attack, doctors say.
Said Brenes: “There’s data to suggest you could cut down the risk of having a heart attack during flu season by almost 45 to 48 percent.”
AVOIDING FLU AND ITS COMPLICATIONS
▪ Get a flu shot. The flu season isn’t over, and the shot can still protect you.
▪ If you get the flu — cough, muscle pains and high fever — call your doctor within 24 hours. Antiviral drugs will help but require a prescription.
▪ If, a week after getting the flu, you have persistent, constant chest pain that isn’t just sore muscles, see a doctor, particularly if you are at high risk for heart problems.
▪ Know the difference between a cold and the flu. The flu usually has a fever, coupled with muscle pain and body aches. The cold normally doesn’t have a fever and it has more sneezing and coughing.
SOURCE: Dr. Harry Aldrich, Miami Cardiac & Vascular Institute, Baptist Health South Florida
This story was originally published February 25, 2018 at 9:00 AM with the headline "The flu and heart attack risks are connected: Get the vaccine, doctors say."