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In early November, Darien Walker, 37, woke up with chest pains, chills, and shortness of breath. “I was nervous about going to the hospital and possibly being exposed to the COVID-19 virus,” Walker said.

She added that she was more afraid of having a heart attack, so she went to the hospital right away.

Walker found out that while she was in the ER, she was given a rapid COVID-19 test, which came back positive. She was also exhibiting all the signs of a heart attack.

“I didn’t see that coming. I always saw myself as the picture of health. I ran three or four times a week, and I hiked on the weekends, weather permitting,” she said.

“The doctor told me that they were seeing a lot of cases of people coming in with symptoms like racing heart rate and difficulty breathing that were triggered by COVID-19.”

Walker said she’s glad she got to the hospital and was treated. Many people put off going to the hospital. “Months later, I still live as a person who has had a heart attack,” she says. “My body doesn’t really care that the damage was caused by COVID-19.”

There have been over 550,000 COVID-19–related deaths in the United States.

According to statistics compiled by the nonprofit American Public Media Research Lab, Black, Pacific Islander, and Indigenous people die from COVID-19 at more than three to four times the rate of white people.

The link between heart disease and COVID-19 is especially disturbing for Black women. Black women and men have had the highest rate of COVID-19 diagnoses and death rates.

Even before the data started coming in on COVID-19–related heart issues, the American Heart Association says nearly 50,000 Black women die each year from non-COVID-19–related heart disease.

That’s why it’s so important for Black women who are living with heart disease to be extra careful.

Nike Shoyinka, MD, the Medical Director of the Ingham County Health Department in Lansing, Michigan, says “COVID-19 has been noted to cause systemic inflammation and increased blood clots, both of which result in heart attacks, pulmonary embolism when it involves the lungs, and a stroke when it involves the neurological system, causing clots in vessels of the brain.”

This disturbing trend doesn’t just impact those with active cases of COVID-19.

Researchers and providers around the country are also reporting that a significant number of people who are recovering from COVID-19 have heart damage that resulted from inflammation caused by the coronavirus, according to the American Heart Association (AHA).

According to the Centers for Disease Control and Prevention (CDC), this includes people who contracted COVID-19 and had mild symptoms. The CDC is tracking COVID-19–related heart failure, coronary artery disease, and cardiomyopathy in people who have had the virus.

“Preventing the development of COVID-19 is the number one thing you can do to prevent related symptoms, ” says Shoyinka.

She recommends that everyone be diligent in wearing masks, washing hands often, and maintaining all of the CDC recommended guidelines for preventing a coronavirus infection.

“Also, in order to stop the spread, get your COVID-19 vaccines when they are available to you,” Shoyinka says.

Since rates of transmission are still high, she also says that “early detection and treatment are key to prevent and reduce dangerous health outcomes cause by complications of COVID-19.”

Shoyinka urges that, “if an individual has worsening symptoms, they shouldn’t delay seeking medical care.”

According to the AHA, people living with heart disease or risk factors such as high blood pressure, should be even more vigilant in trying to prevent contracting the coronavirus and developing COVID-19.

This includes getting the COVID-19 vaccine as soon as possible to prevent severe illness if a positive COVID-19 diagnosis is confirmed.

Many Black women don’t know that they are even at risk.

According to the AHA, as few as 58 percent of Black women know the signs and symptoms of a heart attack, and 36 percent are aware that heart disease is a major health risk for them.

One of those risks is high blood pressure. The AHA says that 40 percent of Black women are living with high blood pressure.

“Individuals with underlying medical conditions, such as high blood pressure, heart disease, and diabetes are at higher risk for complications of COVID, in general,” Shoyinka says.

Even beyond the risks that COVID-19 presents, it’s important to be aware of warning signs of a heart attack. While you may not have all these symptoms, pay attention to:

  • pain or pressure in the chest lasting a few minutes
  • pain in the back, neck, jaw or one or both arms
  • feeling short of breath
  • sweating
  • feeling lightheaded
  • nausea
  • nausea and vomiting
  • severe and unexplained fatigue

Over the last year, in the face of closed doctors’ offices and hospitals with more COVID-19 cases than they can handle, many Black women have not sought out immediate medical attention when faced with the signs that they may be having a heart attack.

Shoyinka says one of the worst things you can do is put off seeking immediate medical attention.

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If you have one or more risk factors for heart attack or stroke, try to work on lowering your manageable risks during the pandemic and beyond.

Here are some things you can do:

  • Be consistent in taking any medications you’re prescribed to manage chronic conditions such as high blood pressure and diabetes.
  • Stay on top of your routine screenings.
  • Check to see if your doctor has telemedicine options, so that you can call in if you’re experiencing symptoms but are hesitant to go to the hospital.

Months after a diagnosis, many people diagnosed with COVID-19, like Walker, are reporting lingering effects such as lung damage, shortness of breath, irregular heartbeat and fatigue long after the virus has cleared their system.

Many medical centers and healthcare professionals are setting up special clinics to follow and provide treatment for damage caused by a bout with COVID-19.

If you’ve had the virus, see if you can schedule screenings for heart damage, blood clots that could cause heart attacks, and other long-term effects on your heart health.

Walker said she stays in close contact with her doctor and has regular imaging and diagnostic tests.

“They have given me a couple of stress tests and check my blood pressure several times since my diagnosis. But I also am not going to let this get me down. I am back to walking and watching what I eat. I am on a blood thinner to protect me from blood clots in my heart or lungs,” she added, hoping that these steps will protect her in the future.

If you’ve had COVID-19, it’s a good idea to get your heart health checked.

Work with your healthcare team to set up appointments for necessary screenings and create a plan of action for addressing any long-haul symptoms and effects.

And if you haven’t had COVID-19, keep taking these precautions to avoid contracting the coronavirus and developing it:

  • wear a mask
  • practice physical distancing and proper handwashing
  • avoid crowded locations
  • get the COVID-19 vaccine when it’s available to you

There are some health conditions, such as previous heart conditions, lung disease, cancer, and more that might make you eligible to get vaccinated sooner.

You can check with your doctor or local public health agencies to see what the criteria are for vaccination in your community.

The Black Women’s Health Imperative (BWHI) is the first nonprofit organization founded by Black women to protect and advance the health and well-being of Black women and girls. Learn more about BWHI by going to