Postural orthostatic tachycardia syndrome after mRNA COVID-19 vaccine, 2022, Ahmed M. Eldokla

Introduction

The diagnostic criteria of postural orthostatic tachycardia syndrome (POTS) require heart rate (HR) increase of > 30 bpm in adults and > 40 bpm in patients aged 12–19 years within 10 min of assuming upright posture without orthostatic hypotension (OH) [1]. Autonomic symptoms and POTS are reported in association with coronavirus disease 2019 (COVID-19) [2, 3]; however, the association between POTS and COVID-19 vaccination is not well studied.

We report five patients who presented to SUNY Upstate Medical University autonomic clinic and dysautonomia center of excellence at UTHealth Houston to evaluate orthostatic intolerance that developed after receiving the COVID-19 vaccine. They were diagnosed with postural orthostatic tachycardia syndrome (POTS) after extensive evaluation. All patients underwent a head-up tilt table (HUTT) test [4]. Furthermore, patients 1 and 2 were examined for Q-Sweat, Valsalva, and heart rate response to deep breathing (HRDB); and patients 3, 4, and 5 underwent heart rate variability (HRV) spectral Fourier analysis [4].

https://link.springer.com/article/10.1007/s10286-022-00880-3

 

If POTS is also a feature of Long Covid, it may turn out to be a balancing act as to whether the protection of the vaccine against Long Covid and so against consequent POTS outweighs the risk of POTS consequent on vaccination.

We do need a wider understanding of POTS and of orthostatic intolerance more broadly, in relation to Covid and to ME, and whether its specific to these conditions or if it is a more general feature of a number of virally triggered conditions.

 

I wonder why POTS is so poorly understood?
It's a very objective diagnosis, you would think by now research would have figured it out. I understand its not that common but there are plenty of rarer illnesses that are far better researched and understood

 

The first rule of medicine is: anything that can be attributed to anxiety/depression/stress/trauma/not-our-problem will be attributed to anxiety/depression/stress/trauma/not-our-problem.

You'll never guess the 2nd rule.

 

I agree but at the same time most of those attributions are because there is nothing measurably wrong, so they can get away with it easily.
The other thing is, despite the efforts of the BPS brigade and others, if there is money to be made selling drugs to cure or treat people, then the space is ripe for pharma companies to make some move or other.

 

I think it depends on who the 'others' are. Vaccine-triggered illnesses can also be a huge liability problem for organisations that heavily fund pharma companies.


[Edited: my bolding]