Regina Juarez, here in an apple orchard, was an outdoors enthusiast and active healthcare worker before contracting COVID-19 in June 2020 and suffering long-term effects of infection. She has seen improvement since seeking care from the LLU International Heart Institute's COVID Heart Clinic. [Photo Courtesy of Loma Linda University Health]
Loma Linda, California, United States | Lisa Aubry

Regina Juarez was an active healthcare worker until struck with a COVID-19 infection in June 2020. She carries lingering effects from the virus into the new year, yet not without a new sense of hope for her health’s gradual improvement since seeking care at Loma Linda University International Heart Institute’s COVID Heart Clinic.

Juarez’s capacity to function as she did before infection eight months ago dramatically decreased, and she continues to experience chest pain, shortness of breath, swelling, palpitations, and fatigue — symptoms which have limited her ability to enjoy treasured moments like hiking with her spouse and grandkids.

“COVID-19 infection is devastating, not just for your physical body while you go through it but also as a life-changing experience,” Juarez says. “If you experience severe symptoms you’re lucky if you’re still here, but you’re not here in the same body that you were before.”

Her cardiologist, Purvi Parwani, MD, co-founder of the LLU COVID Heart Clinic, says Juarez is one of the many patients who have presented with COVID-19-induced heart complications post-infection. Alongside conducting research and providing therapies to alleviate patients’ symptoms, Parwani and other cardiologists at the clinic are determined to pinpoint the true causation of the intense symptoms.

“If we know exactly what we are dealing with, we can come up with a management strategy and better target therapeutics to help these patients,” she says.

Having extensively sifted through others’ accounts of lingering symptoms and comparing them to her own experience, Juarez says she is by no means alone in this struggle. “Even though we don’t know everything about this new disease, I know these things aren’t happening to just me, it’s happening to a lot of people, and it’s very scary.”

From a workup done at the COVID Heart Clinic, Parwani diagnosed Juarez with pericarditis — inflammation of the membrane surrounding the heart. As a result of this plus other heart issues, compounded with newfound cognitive and lung-related hurdles, Juarez says she must be selective about which tasks to tackle in a given day.

This current daily reality presents quite a change of pace for the 55-year-old Highland resident, who had been a home health nurse since her teens and had grown accustomed to snappy daily routines — usually starting at 5 a.m. with some multitasking between house chores, prepping for patient visits, and a morning walk or a swim at the community pool.

Returning from patient visits at around 5 p.m., Juarez would continue house chores, cooking, and caring for anywhere from two to five of her grandkids, depending on the day. After their evening walks and bedtimes, Juarez tended to patient charts before finally going to bed around midnight.

Upon COVID infection, Juarez and her husband spent three weeks quarantining, during which she could not get out of bed without help, much less barely breathe, while experiencing a slew of symptoms — dizziness, weakness, shortness of breath, chest pain, and fevers. Her regular medicine regimen skyrocketed from three medications to 16 different medications, supplements, and inhalers.

“I couldn’t even think straight,” says Juarez, who still experiences brain fog apparent in certain scenarios: “I can’t focus to pay my bills, I can’t remember if I took my pills, or if I grab my phone to text somebody I forget by the time I open my phone.”

Among the multiple specialists managing Juarez’s symptoms, including a pulmonologist cardiologist, and a neurologist, Parwani continues to investigate her case through advanced cardiac imaging. Neither the echocardiogram Parwani says she ordered for Juarez’s significant chest pain nor the subsequent stress test revealed any significant abnormalities. Juarez then underwent a cardiac MRI, which revealed the presence of fluid around the heart.

In the meantime, Parwani developed a stepwise approach to target the best solution for Juarez’s symptoms: diuretics to ward off Juarez’s heart failure-like symptoms, beta-blockers to reduce heart palpitations, and other medications to target the inflammation of the heart lining. Juarez reported a 40–50 percent improvement in her symptoms, which have become both less intense and less frequent since first seeing Parwani last summer.

“To me, that’s a victory because I don’t expect these patients to recover overnight, particularly since we just don’t yet know what exactly is causing these out-of-proportion symptoms when most of the testing is mildly abnormal or normal,” Parwani says.

The COVID Heart Clinic presents new hope for Juarez and countless others who developed cardiovascular complications after contracting COVID-19, Parwani says. She and her fellow colleagues Giv Heidari-Bateni, MD, and Dmitry Abramov, MD, are studying a wide spectrum of incoming patients — from young athletes who were asymptomatic to those whose hearts were significantly impacted during the illness — to find answers and develop effective management techniques post-infection.

“We are looking at what the diagnostics are and developing management techniques to help our patients transition back to normal life,” Parwani says.

Some techniques Juarez has implemented to sustain her well-being since infection, and which she recommends for others in similar positions, include having faith, adopting a positive outlook on hopeful prospects ahead, listening to doctors, recording progress in a journal, and engaging in self-guided education about health conditions and the world’s progress on the COVID-19 battle.

“Have faith, don’t give up, and spread the word about prevention,” she says. “Keep track of any improvement — it uplifts your spirit, which I believe has a positive effect on healing.”

Juarez said she plans to get the vaccination for COVID-19 once it is available to her (see this article to learn about COVID-19 vaccines for people with cardiovascular concerns).

If you or someone you know suffered from a COVID-19 infection and continues to experience cardiovascular symptoms, experts at LLU’s COVID Heart Clinic are at your service. To learn more, visit the website or call 800-468-5432 to schedule an appointment.

This article was originally published on the Loma Linda University Health news site

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