Reddy Sujana, Reddy Satvik, Arora Manish
Internal Medicine, Alabama College of Osteopathic Medicine, Dothan, USA.
Internal Medicine, Decatur-Morgan Hospital, Decatur, USA.
Cureus. 2021 May 4;13(5):e14837. doi: 10.7759/cureus.14837.
Postural orthostatic tachycardia syndrome (POTS) is an impaction of the autonomic nervous system initiating orthostatic tachycardia. There are numerous triggers for POTS including viruses, vaccines, and an autoimmune basis. This case report is clinically relevant to better understand the pathophysiology behind the messenger RNA (mRNA) coronavirus disease 2019 (COVID-19) vaccine and the mechanism that triggers autonomic nervous system dysfunction. Furthermore, the overall goal of this case study is to report a unique side effect associated with the novel mRNA COVID-19 vaccine. A 42-year-old male, with no prior symptoms of sinus tachycardia and presyncope episodes, is diagnosed with POTS secondary to the first dose of the mRNA COVID-19 vaccine. Symptoms to this date include sinus tachycardia, dizziness, headaches, and fatigue that are often triggered after a large meal or standing for a longer duration. Numerous diagnostic tests and images failed to confirm any other diagnosis other than POTS. There was a sequential connection between the onset of symptoms approximately one week after taking the first dose of the mRNA COVID-19 vaccine. Currently, POTS in this patient is controlled by lifestyle modification. This case report has broader implications as it can help us understand how the mRNA vaccine works on the body relative to the immune system. Our theory is that the development of antibodies activates an autoimmune reaction that triggers POTS disease. The prevalence of the POTS dysautonomia post-vaccination will be clearer as more data and research are conducted on the side effects from the innovative mRNA vaccines created to combat severe acute respiratory syndrome coronavirus 2.
体位性直立性心动过速综合征（POTS）是自主神经系统功能紊乱引发的直立性心动过速。POTS有多种诱因，包括病毒、疫苗以及自身免疫因素。本病例报告对于更好地理解2019冠状病毒病（COVID-19）信使核糖核酸（mRNA）疫苗背后的病理生理学以及引发自主神经系统功能障碍的机制具有临床意义。此外，本病例研究的总体目标是报告一种与新型mRNA COVID-19疫苗相关的独特副作用。一名42岁男性，既往无窦性心动过速和晕厥前发作症状，在接种第一剂mRNA COVID-19疫苗后被诊断为继发性POTS。至今的症状包括窦性心动过速、头晕、头痛和疲劳，常在大餐后或长时间站立后引发。多项诊断检查和影像学检查未能确诊除POTS以外的任何其他疾病。在接种第一剂mRNA COVID-19疫苗约一周后症状开始出现，两者之间存在先后关联。目前，该患者的POTS通过生活方式调整得到控制。本病例报告具有更广泛的意义，因为它可以帮助我们了解mRNA疫苗相对于免疫系统在人体上的作用方式。我们的理论是抗体的产生激活了自身免疫反应，从而引发POTS疾病。随着针对严重急性呼吸综合征冠状病毒2研发的创新型mRNA疫苗副作用方面有更多数据和研究，接种疫苗后POTS自主神经功能障碍的患病率将更加明确。
