Overlapping Myocarditis and Postural Orthostatic Tachycardia Syndrome After COVID-19 Messenger RNA Vaccination: A Case Report

The worldwide spread of the coronavirus disease 2019 (COVID-19) pandemic and the significant morbidity and mortality rate associated with it led to the rapid development of several COVID-19 vaccines. While serious side effects related to the vaccines are rare, various adverse events have been report...

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Published inCurēus (Palo Alto, CA) Vol. 14; no. 11; p. e31006
Main Authors Sanada, Yuichi, Azuma, Junji, Hirano, Yasuhiro, Hasegawa, Yasuhiro, Yamamoto, Takehisa
Format Journal Article
LanguageEnglish
Published United States Cureus Inc 02.11.2022
Cureus
Subjects
Blood pressure
Cardiac arrhythmia
Cardiology
Case reports
Coronaviruses
COVID-19 vaccines
Fatigue
Guillain-Barre syndrome
Headaches
Heart rate
Myocarditis
Neurology
Orthostatic hypotension
Pathophysiology
Patients
Pediatrics
Severe acute respiratory syndrome coronavirus 2
Sleep
Ultrasonic imaging
covid-19
vaccine
myocarditis
droxidopa
postural orthostatic tachycardia syndrome
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Summary:The worldwide spread of the coronavirus disease 2019 (COVID-19) pandemic and the significant morbidity and mortality rate associated with it led to the rapid development of several COVID-19 vaccines. While serious side effects related to the vaccines are rare, various adverse events have been reported to occur after COVID-19 messenger RNA (mRNA) vaccination, including myocarditis, Guillain-Barré syndrome, and thrombosis. Postural orthostatic tachycardia syndrome (POTS) is a chronic cardiovascular dysautonomia among young and middle-aged individuals. Although the pathophysiology of POTS is thought to be heterogeneous, vaccine-induced immune-mediated autonomic dysfunction is hypothesized to be one cause of the syndrome. In this report, we present a case of myocarditis and POTS occurring in a 13-year-old male following COVID-19 mRNA vaccination. He presented with persistent severe fatigue and headache. The patient's symptoms improved after intravenous immunoglobulin for myocarditis, non-pharmacologic interventions, and multiple medications for POTS.
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.31006