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

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Cureus


. 2022 Nov 2;14(11):e31006.
doi: 10.7759/cureus.31006. eCollection 2022 Nov.
Overlapping Myocarditis and Postural Orthostatic Tachycardia Syndrome After COVID-19 Messenger RNA Vaccination: A Case Report


Yuichi Sanada ¹ , Junji Azuma ¹ , Yasuhiro Hirano ¹ , Yasuhiro Hasegawa ¹ , Takehisa Yamamoto ¹



Affiliations

• PMID: 36475233
• PMCID: PMC9717213
• DOI: 10.7759/cureus.31006

Abstract

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.

Keywords: covid-19; droxidopa; myocarditis; postural orthostatic tachycardia syndrome; vaccine.