Many who are on the mend from COVID-19 may have noticed a confusing symptom plaguing them for weeks: a sudden, unexplained spiking of their heart rate.
For some people, it’s a brief, uncomfortable reminder of the acute phase of illness while they work back towards their usual level of fitness.
But heart palpitations and confusing spikes in heart rate are also one of the most common symptoms plaguing those with long COVID, a little-understood condition that can linger for months or even years after a person first contracted the virus.
While this cardiac symptom doesn’t appear to stem from long-term damage to the heart, experts say, spiking heart rates can provide anxiety and discomfort for thousands of Canadians, disrupting their lives and activities.
“Think of your body as an automatic car,” Dr. Angela Cheung told CTVNews.ca. “And there’s disturbance there, meaning it’s not responding appropriately or it’s taking longer to respond appropriately. So that’s really what’s happening.”
So how do you tell the difference between a temporary issue and a larger problem that needs medical advice?
HIGH HEART RATE AFTER COVID-19
Patients dealing with cardiac symptoms of long COVID is something that Dr. Ian Paterson sees a lot.
Paterson, a cardiologist and professor at the University of Alberta, works at the Mazankowski Alberta Heart Institute, where he has had many patients referred to him because of their cardiac issues following COVID-19 infections.
“Palpitations or erratic heart beat, yeah, that would rank up there as one of the more common symptoms that I get asked to provide advice about,” he told CTVNews.ca in a phone interview, adding that chest pain is another common symptom he is asked about.
“Some patients have these spikes in their heart rate, often the spikes happen with minimal activity.”
Last summer, Paterson helped the Canadian Cardiovascular Society to create a primer for physicians to help in treating long COVID patients with cardiac symptoms.
For some patients who experience spiking heart rates in the first few weeks after illness, this may not be a precursor of long COVID, but a part of the healing process.
“If a patient was quite ill and was on bedrest for several weeks, then the body rapidly loses muscle mass and you lose a good amount of your fitness,” Paterson said. “And so when you exert yourself, you will have higher heart rates with exertion and even at rest, because you’re just not at the same level of fitness that you were before your illness.”
Vancouver resident Angela Inglis believes this is what happened to her.
The 41-year-old fell ill with COVID-19 around Jan. 21. Her entire family caught the virus through her son’s daycare, and battled the illness for around two weeks at home.
But after the intense stage of sickness passed, another issue arose: an uneasily high heart rate.
“When I started to try to work out again, which was probably too soon, I noticed that I felt like my heart was beating faster than the energy I was exerting,” she told CTVNews.ca. “So I felt like I was getting heart palpitations.”
She even felt like her heart was racing when she tried to fall asleep.
“I wasn’t sure if it was anxiety or if it was something to be more concerned about.”
She was able to get in touch with Paterson to explain her symptoms in mid-February. He reassured her that she was missing some of the accompanying symptoms that might indicate a larger problem, and that her symptoms were common.
“It’s helpful to know that what I had experienced is not necessarily outside of the ordinary for COVID and that, it doesn’t mean there’s something wrong with my heart,” she said.
Now, around a month since she first caught COVID-19, she says her heart rate feels like it is returning to normal.
But for many people, their cardiac symptoms don’t go away in a month.
Instead it becomes part of long COVID, a condition which can impact multiple organ systems and includes a wide range of symptoms.
“In terms of the frequency in long COVID, my understanding of the literature is about 25 to, let’s say, 30 per cent of patients with long COVID syndrome will have chest pain and/or palpitation type symptoms,” Paterson said.
“[And] long COVID appears to happen just as common in people that had mild initial cases of COVID compared to hospitalized patients. So it’s not more common in the people who are hospitalized.”
HIGH HEART RATE AND LONG COVID
Long COVID is considered by some physicians and guidelines to be any symptoms that extend beyond four weeks after a person has caught COVID-19.
But in October, WHO came out with a clinical case definition, stating that symptoms were part of long COVID only if they extended past three months since the first onset of COVID-19.
“The most common [symptoms of long COVID] are fatigue, brain fog, tachycardia or fast heart rate, shortness of breath and sleep disturbances. Those are the top five,” Cheung told CTVNews.ca in a phone interview.
Cheung, a professor at the University for Toronto and senior scientist at the University Health Network, is co-lead on The Canadian COVID-19 Prospective Cohort Study (CANCOV), a Canadian project looking to research outcomes up to two years after contracting COVID-19.
“There are many cardiac things that can happen post COVID,” she said. “What I would call inappropriate sinus tachycardia is something that we do see.”
Inappropriate sinus tachycardia (IST) is when the heart beats very quickly without a clear reason.
She said that most heart rate issues seen in long COVID patients are probably IST, but some appear to be more similar to another condition.
“We don’t understand fully why, but some patients with post COVID syndrome are at risk for developing cardiac dysautonomia, and another condition called POTS, which stands for postal orthostatic tachycardia syndrome,” Paterson said.
“And that’s fancy words for meaning your heart rate shoots up when you stand, when you get up to a standing position or when you exert yourself, you have inappropriate increases in heart rate.”
POTS isn’t just an elevated heart rate — it also involves abnormal blood flow throughout the body. Patients experiencing symptoms of POTS are often diagnosed with IST if they don’t fulfill all the criteria of POTS, Cheung said.
It’s known that COVID-19 affects the cardiovascular system. The virus increases the risk of developing myocarditis, an inflammation of the heart, and studies have suggested that those who have recovered from COVID-19 are at a higher risk for heart attack and stroke.
But scientists aren’t 100 per cent sure yet why these cardiac symptoms arise and persist in long COVID patients.
“COVID affects our autonomic nervous system,” Cheung said. “And so there’s a bit of an imbalance in the autonomic nervous system and there’s decreased parasympathetic activity which may explain this phenomenon.”
A review of the major studies on long COVID and the cardiovascular system which was published this month in the European Heart Journal listed a number of factors that may play into ongoing cardiac issues, including that there could be injury to tiny blood vessels in the heart causing stress, or that there could be a chronic inflammatory response.
“The most prevailing theory is it’s somehow caused by a low level of ongoing inflammation that people have following their illness, that the body, for some reason, in, in these patients, […] the inflammation was activated after their illness,” Paterson explained.
“And it just is persisting much, much longer than it should.”
He said that some blood tests can show evidence that the immune system is still active at a level it shouldn’t be.
“We measure something called CRP or D-dimers,” Paterson said, explaining that high levels of these in the body can be markers for long COVID.
Not every long COVID case has these markers, he cautioned, but “in some cases we do see these markers in terms of the specific cardiac issues.”
THE ROAD TO RECOVERY
The good news for those who might be experiencing jumps in their heart rate after COVID-19 is that it’s not a life-threatening issue or necessarily indicative of underlying heart damage.
“That’s the first thing I tell the patient. I’d say, ‘Yes, what you’re having is uncomfortable. Yes, you’re getting tired more easily, but this is something which should improve over time and is not life threatening,’” Paterson said.
“We’ll often also send these patients for a heart ultrasound and in all the cases that I’ve been involved with, their heart function has been normal.”
Paterson said that with his patients who have POTS, hydration is important, and sometimes they are told to wear compression garments such as stockings in order to help their blood circulation and return blood to their heart.
While treating long COVID is still a field with a lot of “trial and error,” physical therapy is involved in many treatment plans for these cardiac symptoms, he said.
“In many centers in Canada and really throughout the world, there have become specialized exercise programs for patients with long COVID that really have become personalized for these patients, depending on the symptoms that they’re having,” he said.
“What I’ve been doing is I’ve been referring patients to these more specialized physiotherapy groups.”
One type of physical therapy that people with cardiac dysautonomia might do is to slowly move from exercise lying in a recumbent position to a standing position over a period of time to help the body adjust, he said.
“I have had some patients that I follow up with and for the most part, the symptoms seems to improve,” Paterson said. “It can take a while and that’s what I usually warn them is depending on their level of disability, it can take [months].”
He said in a handful of cases the patient said they only started feeling close to normal after six months of dealing with these symptoms.
Both Cheung and Paterson said that when we talk about these cardiac symptoms with long COVID, it’s important not to spread alarm.
“What I would say about cardiac issues in long COVID is these are real issues that these patients have and at the same time, I think these are treatable issues and I wouldn’t view them as life threatening,” Paterson said, reiterating that there hasn’t been a connection found between spiking heart rates in long COVID and underlying heart damage.
“I think with the right help, people can improve from these issues.”
But at the same time, it’s important to educate people and provide support to those who may be struggling with these symptoms and feeling unsure if they’re overreacting or not.
“If your heart was going very quickly, yes, you would feel lightheaded and in a severe case, you could pass out,” Paterson said. “Does it affect people’s day to day living and what they’re able to do? Absolutely.”
Cheung said if a person is experiencing persistent chest pain after COVID-19, they shouldn’t wait until three months have passed to reach out to a medical professional about long COVID.
With milder symptoms such as a high heart rate, a person could try to rest, go slowly when returning to physical activity, and see if the issue is continuing beyond the few weeks it might take to regain physical fitness.
Inglis said it was helpful to her to reach out for advice even though only a few weeks had passed since she contracted COVID-19.
“It was certainly feeding into anxiety,” she said of her heart palpitations, adding that she recommended people ask their doctor about their concerns.
Most people with long COVID will have more than one symptom, Cheung said.
“A lot of people not only have cardiac symptoms, they also have brain fog and they also have fatigue,” she said.
“Some of these things that we’re talking about [with long COVID], we’re not talking about weeks, we’re talking about months to years. So some people have had it for two years and really don’t want that, right. It’s very debilitating. It affects quality of life.”
Skinstitut Holiday Gift Kits take the stress out of gifting
Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.
In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.
“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.
There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.
Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.
Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.
In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.
Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.
LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?
It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.
Here’s how you can prepare your digital life for your survivors:
Apple
The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.
For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.
You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.
Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.
Google
Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.
When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.
You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.
There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.
Facebook and Instagram
Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.
When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.
The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.
You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.
TikTok
The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.
Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.
X
It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.
Passwords
Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?
Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.
But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.
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Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.
The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.
New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.
The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.
Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.
Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.
“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.
“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”
McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.
But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.
The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.
He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.
“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.
“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.
McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”
McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.
He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.
“Early identification of reading difficulty can truly change the trajectory of a child’s life.”
This report by The Canadian Press was first published Oct. 23, 2024.
