Vaccines can occasionally cause tachycardia. The mechanism for tachycardia in our patient remains unclear. Unlike these patients who experienced a multitude of signs and symptoms, our patient experienced only isolated tachycardia.
described a patient developing a new-onset postural orthostatic tachycardia syndrome which occurred after the administration of the Pfizer-BioNTech COVID-19 vaccine. All three physicians had previously tested positive for COVID-19. In this case series, the tachycardia occurred within 24 hours after immunization and lasted a total of 16 hours, similar to our case. reported on three physicians who received this vaccine and developed tachycardia in the absence of fever after immunization. Tachycardia has been twice previously described as a side effect of the Pfizer-BioNTech COVID-19 vaccine. On outpatient follow-up, patient’s tachycardia had resolved by the following day, and on subsequent follow-up, the tachycardia did not recur. The patient was given a dose of metoprolol orally and discharged home. Despite all these measures, the tachycardia persisted. Ativan (lorazepam) and Tylenol were also administered. Three liters of lactated ringers were administered, even though the patient did not appear dehydrated. The patient was afebrile and hemodynamically stable, except for the tachycardia (heart rate (HR): 130s). Computed tomography of the chest showed no evidence of pulmonary embolism or any identifiable pathology.
Pregnancy test, urinalysis, and urine drug screen were negative. Electrocardiography (ECG) showed sinus tachycardia with no ST or T-wave abnormalities. A complete blood count (CBC), basic metabolic panel (BMP), thyroid-stimulating hormone (TSH), free thyroxine (free T4), D-dimer, and two sets of high-sensitivity troponin were all within normal limits (Table (Table1). She was not under stress, did not drink a significant amount of caffeine, denied using any drugs or taking any over the counter medications (including herbals or supplements), and had no other symptoms to suggest another etiology, such as an infectious process. There was no alcohol use to raise concern for possible withdrawal. There was no bleeding, dark or tarry stools, or change in menstruation. She denied any chest pain, dyspnea, vomiting or diarrhea, cough, abdominal pain, genitourinary symptoms, rash, or travel. Her initial vital signs were temperature 37.4˚C, blood pressure 152/99, heart rate 135, and 100% oxygen saturation. A 29-year-old woman presented with palpitations that started approximately six to eight hours after administration of her second Pfizer-BioNTech COVID vaccination.
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