COVID-19 Vaccination and POTS

A recent study conducted by the Smidt Heart Institute at Cedars-Sinai sought to explore the potential correlation between COVID-19 vaccination and a challenging-to-identify heart condition known as postural orthostatic tachycardia syndrome (POTS).

The study confirmed that individuals who received a COVID-19 mRNA vaccine and later experienced new or worsened POTS already had preexisting conditions that could contribute to a POTS diagnosis.

POTS involves dysfunction of the nervous system, leading to an abnormal increase in heart rate upon standing or sitting up. Traditionally affecting women of childbearing age, during the COVID-19 pandemic, men were equally affected in cases of POTS development.

Dr. Peng-Sheng Chen, the study’s corresponding author and an internationally recognized expert on the condition, revealed surprise that all patients in the small cohort had conditions predisposing them to POTS even before vaccination.

These conditions included palpitations, rapid heart rates, orthostatic intolerance, hypermobile joints, asthma, systemic lupus, fainting, and chronic abdominal pain. Dr. Chen emphasized the importance of monitoring individuals with underlying health issues after COVID-19 vaccination for potential post-vaccine POTS.

The observational study, recently published in the peer-reviewed journal Heart Rhythm and presented during the American Heart Association Scientific Sessions, analyzed data from 10 patients treated at Cedars-Sinai’s multidisciplinary POTS clinic between July 2021 and June 2022. With guideline-directed care, all participants reported improvements in their POTS condition.

Despite the association found between POTS and COVID-19 vaccination, a previous investigation across the Cedars-Sinai Health System showed that patients diagnosed with COVID-19 were five times more likely to develop the cardiac condition after infection compared to after vaccination.

Dr. Debbie L. Teodorescu, a cardiology fellow at the Smidt Heart Institute and the study’s first author, highlighted the considerable impact of COVID-19 infection on triggering or revealing POTS or POTS-like conditions worldwide.

While most patients responded well to treatment in their cohort, subsequent COVID-19 infections tended to significantly impede recovery. Hence, the researchers strongly recommended patients be vigilant in avoiding COVID-19 exposure.

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