Just days after news that the first deaths from the coronavirus in California occurred weeks earlier than experts realized, a report from the San Francisco Chronicle is shedding light on exactly what caused one of those cases to turn fatal.
The report zeroes in on the case of a 57-year-old woman whose daughter found her dead, on Feb. 6, of an apparent heart attack in Santa Clara, Calif. The official autopsy report, obtained by the Chronicle, reveals that the woman died of “acute hemopericardium” (meaning accumulation of blood around the heart) due to the “rupture of [the] left ventricle.” The report also notes that the woman’s heart was inflamed and lists the causal factor in her death as “COVID-19.”
The news is further evidence that the coronavirus has the ability to impact many organs in the body, not just the lungs. But what exactly does it mean that her heart ruptured, and how common is that? Dr. William Schaffner, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, tells Yahoo Life the fact that her heart burst is unusual.
“She had a bad heart attack — so bad that it actually ruptured through the wall of the heart,” Schaffner says. “That was the cause of death, and they found in a number of her organ systems, including the heart, evidence of the virus. So that reinforces the notion that, at least in some patients, the virus itself can get out of the lungs, probably via the bloodstream.”
In an interview with the Chronicle, California-based forensic pathologists agreed that the severity of this heart attack is not typical. “There’s something abnormal about the fact that a perfectly normal heart has burst open,” Dr. Judy Melinek said. “The heart has ruptured. Normal hearts don’t rupture.”
A 2012 paper on cardiac ruptures published in Science Direct lists the phenomenon as “rapidly fatal,” saying that it’s the most common cause of death from blunt force trauma. “Most cases of cardiac rupture result from high-energy impacts, such as those sustained in motor vehicle accidents or falls from great heights,” the authors write.
Although the severity of the heart attack may have been abnormal, Schaffner says the fact that the virus traveled is not. “[The bloodstream] is the way viruses usually are distributed in the body, and it can settle and find receptors in other tissues and cause damage in those tissues,” he says. “And that may be part of the reason these people in intensive care units can have multi-organ failure.”
Other coronaviruses, such as SARS and MERS, he says, have been found in other organs, but COVID-19 seems particularly formidable — and capable of causing major damage. To be sure, the vast majority of those who contract the virus make a full recovery, with many showing no symptoms at all. But for a small number, as the autopsy shows, it can prove extremely dangerous.
“Once [the virus] gets into you, it can do nasty things and it can involve organs other than the lung,” says Schaffner. “How frequently that happens, we’re not quite sure yet.”
For the latest coronavirus news and updates, follow along at https://news.yahoo.com/coronavirus. According to experts, people over 60 and those who are immunocompromised continue to be the most at risk. If you have questions, please reference the CDC’s and WHO’s resource guides.
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