RSV and Heart Health

What is RSV?

Respiratory Syncytial Virus, often called RSV, is a common respiratory virus. Nearly all children will contract RSV by the time they’re two, and it affects about 65 million people every year. 

For most people, RSV involves mild, cold-like symptoms, and you’ll probably feel better in a week or two. But for others, especially in high-risk groups like infants and older adults, RSV can be serious and can even lead to hospitalization. 

More severe cases of RSV can cause bronchiolitis and pneumonia. It can also escalate chronic health issues like asthma and congestive heart failure. Serious cases of RSV can also have serious implications on your heart health. The good news for older adults is that a new vaccine has been approved. (Read on for more details.)

Diagnosing RSV and preventing its spread

Many people think of RSV as a seasonal illness that starts in the fall and peaks in winter. But COVID-19 disrupted some of its predictability in 2020, and experts are uncertain what to expect into the future.

It can be difficult to distinguish RSV from other seasonal respiratory illnesses, like influenza and the cold, because they share many symptoms including coughing, sneezing, and congestion. Your doctor can conduct special tests to determine the specifics of your illness.

If you’re an older adult with cardiovascular disease (CVD) or related risk factors, and you have respiratory symptoms, it’s important to visit your health care professional because you might have RSV. Because RSV is contagious, your doctor can help you take steps to prevent the spread, manage your condition and watch for worsening CVD symptoms that could require hospitalization.

Impact of RSV in adults

In the United States alone, up to 160,000 adults are hospitalized every year for more serious cases of RSV. There’s a strong correlation between RSV and heart health in more serious cases of RSV. 

Around 14 to 22% of hospitalizations for adult patients are complicated by cardiovascular issues including worsening congestive heart failure, acute coronary syndrome and arrhythmias. Underlying cardiovascular disease has also been linked to 45 to 63% of adult hospitalizations for RSV. 

Are you at risk?

If you’re an older adult or an adult with chronic medical conditions, you may face an increased risk of severe RSV and cardiovascular complications. Some people who face the highest risk of RSV include:

• Adults 75 and older
• Adults with weakened immune systems
• Adults with chronic medical conditions like lung disease, cardiovascular diseases including congestive heart failure and coronary artery disease, kidney disorders and neurologic conditions.

What are the symptoms of RSV?

If you have RSV, you’ll probably show symptoms within four to six days of getting infected. Symptoms can include:

• Runny nose
• Decrease in appetite
• Coughing
• Sneezing
• Fever
• Wheezing

These symptoms usually appear in stages and not all at once.

How is RSV treated?

Most RSV infections go away on their own in a week or two, and antiviral medication isn’t usually recommended. But there are some things you can do to relieve symptoms.

Drink enough fluids. Don’t forget to drink plenty of fluids. You’ll prevent dehydration (loss of body fluids).

Stay on top of fever and pain with over-the-counter fever reducers and pain relievers, including acetaminophen or ibuprofen.

Talk to your health care professional if your symptoms become severe. It's important to remember that RSV can cause severe illness in some people.

Complications from RSV

While most cases of RSV will remain mild, serious complications can occur. This includes bronchitis, pneumonia and worsening conditions like asthma, chronic obstructive pulmonary disease and congestive heart failure.

Studies have shown that up to 22% of hospitalized adults experience cardiovascular complications, such as worsened congestive heart failure, new arrhythmia and stroke. 

It’s important to understand the heightened risks you could face and the best way to protect yourselves and your loved ones, especially if you’re in a more vulnerable population.

RSV infections can be dangerous for certain adults. Each year, it is estimated that between 60,000-160,000 adults ages 65 and older in the United States are hospitalized and 6,000-10,000 of them die due to RSV infection. Adults at highest risk for severe RSV infection include:

• Older adults, especially those 65 years and older
• Adults with chronic heart or lung disease
• Adults with weakened immune systems

What to know about RSV and your heart health

If you have a heart condition, it’s critical to pay special attention and see your health care professional for advice. Severe cases of RSV can be complicated by cardiovascular issues, which can lead to hospitalization and even death. 

Studies have shown that up to 63% of hospitalized adults with RSV have underlying cardiovascular disease. And 14-22% of adult patients hospitalized for RSV deal with cardiovascular complications including worsening congestive heart failure, acute coronary syndrome and arrhythmias. 

Researchers believe RSV primarily impacts cardiovascular health through the respiratory tract.

RSV has also been linked to myocardial damage. It can also lead to ischemia (an inadequate blood supply to the heart) and increased risk of atrial fibrillation (an irregular, fast heartbeat).

RSV and heart complications

RSV has been associated with worsening cardiovascular conditions such as arrhythmias, heart failure and heart attack, both in patients with and without known diagnoses of these conditions.

• Heart attack and stroke – Patients face a higher risk of heart attack or stroke immediately after contracting RSV. The highest risk is within three days of infection but remains heightened for up to 90 days.
• Congestive heart failure – Adults with CHF and RSV are more likely to require inpatient care. Researchers found patients with CHF had eight times the rate of hospitalizations than those without. And over 5% of all hospitalizations for CHF during RSV season are due to RSV infection. The news is worse for older adults. One study found that 20% of elderly patients who had been admitted due to RSV had a primary discharge diagnosis of CHF.
• Coronary artery disease – High rates of underlying CAD have been found in patients with RSV, though one study found that those patients were more likely to receive outpatient care than inpatient. 

When it’s a severe infection

When an adult gets RSV infection, they typically have mild cold-like symptoms, but some may develop a lung infection or pneumonia. RSV can sometimes also lead to worsening of serious conditions such as:

• Asthma
• Chronic obstructive pulmonary disease (COPD) – a chronic disease of the lungs that makes it hard to breathe
• Congestive heart failure – when the heart can’t pump enough blood and oxygen through the body

Older adults who get very sick from RSV may need to be hospitalized. Some may even die. Older adults are at greater risk than young adults for serious complications from RSV because our immune systems weaken when we are older.

Avoiding RSV

There are some simple steps you can take to stay healthy and avoid RSV.

Wash your hands. Use soaps and water or an alcohol-based hand sanitizer.

Don’t touch your face with unwashed hands. This is how we spread germs.

Stay away from sick people. Don’t kiss or share cups or eating utensils with friends or family if they have cold-like symptoms. 

Cover your coughs and sneezes. Need to cough or sneeze? Be sure and cover your mouth and nose with a tissue or your shirt sleeve. Of course, toss your tissue in the trash.

Clean, clean, clean! Make a mental note to clean and disinfect surfaces and objects that people frequently touch, including toys, doorknobs and mobile devices. Do this and you’ll help ditch the germs.

Feeling sick? Stay home. You don’t want others to catch the illness. Protect those around you by avoiding work, school and public areas. 

Feeling sick? Read the do's and don'ts to help you get better and protect others when you have a virus.

The RSV vaccine

A vaccine is now available for older adults. The CDC recommends the RSV vaccine for the following people:

• Everyone ages 75 and older
• Adults ages 60-74 at increased risk of severe RSV
• Adults 60-74 who are at increased risk include those with chronic heart or lung disease, certain other chronic medical conditions, and those who are residents of nursing homes or other long-term care facilities

Vaccines for pregnant people or monoclonal antibody products are also available to protect infants and young children from severe RSV.

RSV vaccine is not currently an annual vaccine, meaning older adults do not need to get a dose every RSV season. If you got your RSV vaccine last year, you won’t need another one this year.

The best time to get vaccinated is in late summer and early fall — just before RSV usually starts to spread in the community.  

Research shows one shot could reduce the risk of symptomatic illness by 83% and of severe illness by 94%. It’s especially important for older patients with cardiopulmonary issues to get the vaccine.

If you have questions about the RSV vaccine and if it’s right for you, talk to your health care professional.