20-05-2025
How a respiratory virus could trigger heart failure: What you should know about HMPV
OFTEN mistaken for the common cold, Human Metapneumovirus (HMPV) is gaining attention from cardiologists for its hidden danger — especially to those with pre-existing heart conditions. Sri Kota Specialist Medical Centre Consultant Cardiologist and Physician Dr. G.S. Sridhar explains how this respiratory virus can quietly strain the cardiovascular system and even trigger life-threatening complications in vulnerable individuals.
Human Metapneumovirus (HMPV) is a respiratory virus known to cause both upper and lower respiratory tract infections. While it usually results in mild cold-like symptoms in healthy adults, the virus poses a more serious risk to high-risk groups such as the elderly, young children, and individuals with chronic health issues — particularly those with cardiovascular disease.
'Respiratory infections can reduce oxygen levels, increase inflammation, and strain the cardiovascular system, potentially worsening heart disease or triggering serious complications like heart failure or arrhythmias,' Dr Sridhar said.
According to the Health Ministry, Malaysia saw 327 cases of human metapneumovirus (HMPV) infections in 2024, a 45 per cent rise from the 225 cases in 2023.
HMPV is a relatively recent discovery in human respiratory viruses and, like Respiratory Syncytial Virus (RSV), can cause conditions ranging from asymptomatic infection to severe bronchiolitis. Consultant Cardiologist and Physician Dr. G.S. Sridhar explains how this respiratory virus can quietly strain the cardiovascular system and even trigger life-threatening complications in vulnerable individuals.
How The Immune System's Response Can Strain The Heart
=When someone contracts a virus like HMPV, the body responds by activating its immune defenses. This response involves the release of cytokines, proteins that initiate inflammation to help eliminate the virus. But in some cases, particularly for people with pre-existing heart conditions, the inflammation becomes excessive and places stress on the heart.
'This inflammation causes the heart to work harder, which can be risky for older adults or people with existing heart conditions like high blood pressure, heart disease, or blocked arteries,' Dr Sridhar said.
This strain intensifies during fever or tachycardia, a condition that causes irregular rapid heartbeat, where the heart's demand for oxygen increases. At the same time, the body undergoes vasoconstriction, otherwise described as the tightening of blood vessels, and fluid shifts, making it more difficult for the heart to function efficiently.
These conditions can overwhelm an already compromised cardiovascular system, increasing the risk of acute decompensation, heart failure, or other severe events.
'The same inflammation can also disturb plaque buildup in the arteries — a dangerous event that could lead to a heart attack,' he added.
Common Heart Complications From HMPV and How Quickly They Can Escalate
Although many patients recover from respiratory infections without lasting issues, Dr Sridhar cautioned that some individuals may develop serious cardiac complications — and symptoms can worsen and progress very quickly, often within just days of infection.
According to him, the most common heart-related complications following a respiratory virus like HMPV include:
"Heart failure, where the heart can't pump blood as well as it should. Arrhythmias, irregular heartbeats that can be dangerous if not treated. Finally, Myocarditis, inflammation of the heart muscle, often caused by the virus itself or the immune response to it." Dr. Sridhar stated.
Alternatively, another serious risk is acute coronary syndrome (ACS), which includes conditions like heart attacks.
A landmark study published in the New England Journal of Medicine found that patients were six times more likely to suffer a heart attack in the week following a respiratory viral infection like influenza. Though HMPV is newer to medical research, similar risks are under close investigation.
This sentiment is echoed by cardiologist Dr V. Corrales-Medina, who noted in a medical journal published in 2013:
'An infection can act as a trigger that sets off a chain reaction in the body, leading to heart problems that otherwise might not have surfaced.' HMPV is a relatively recent discovery in human respiratory viruses and, like Respiratory Syncytial Virus (RSV), can cause conditions ranging from asymptomatic infection to severe bronchiolitis. Photo: Canva
Importance of Early Detection and Awareness
Given how fast heart-related complications can appear, Dr Sridhar advised people — especially older adults and those with chronic heart disease — to take any signs of chest discomfort, shortness of breath, or unusual fatigue during or after a respiratory infection seriously.
"What makes this more concerning is how quickly symptoms can appear and worsen.
'Delaying care increases the risk of permanent heart damage or even sudden death,' he warned.
Even as HMPV continues to fly under the radar compared to viruses like Covid-19 or influenza, its potential cardiovascular effects make it a threat that should not be ignored — particularly by those already living with heart disease.
As more respiratory viruses emerge or re-emerge, the line between lung and heart health becomes increasingly blurred. The case of HMPV underlines the importance of proactive healthcare, especially for those in vulnerable groups.
In light of the concerning rise of HMPV, it is advised by many health experts such as Dr Sridhar, to go for regular health screenings, vaccination where applicable, and immediate medical attention when symptoms arise as critical strategies for protecting heart health during respiratory illness seasons.
