Post-Vaccine Heart Issues: Should You Get the Second Dose?

After receiving the COVID-19 vaccine

Hello, doctor: After receiving my first dose of the BNT vaccine, I soon experienced chest tightness and a spike in blood pressure over 190.
Due to my anxiety, the clinic staff advised me to relax and rest a bit before measuring my blood pressure again, which then dropped to over 160, still quite high.
I gradually started to feel feverish, and after nearly an hour, my symptoms remained the same.
The clinic provided me with a referral to a hospital, suggesting that if I felt really unwell, I should go directly to the emergency department of a major hospital.
When I stood up to leave, I felt more pronounced chest tightness and discomfort, so I went straight to the emergency room.
Walking to the ER entrance, I felt quite breathless.
My blood pressure was still over 160, and my heart rate was elevated.
An ECG was performed (my heart rate was a bit fast, but it appeared normal).
The doctor prescribed me Entresto and Anxiolytic tablets.
After taking them and getting some sleep, my symptoms disappeared, and my blood pressure returned to normal.
I am now due for my second dose and am hesitant about whether to proceed.
1.
The clinic initially advised against the second dose due to my side effects.
2.
At the major hospital, it seemed my symptoms were related to anxiety; is it still appropriate for me to receive the second dose? If not, what alternative should I consider? 3.
Should I take the Anxiolytic tablet (0.5 mg) before the vaccination, or should I wait until after?

Xiao Zhen, 30~39 year old female. Ask Date: 2022/02/09

Dr. Wu Xueming reply Cardiology

1.
If the side effects are severe, one can choose a vaccine with fewer side effects (e.g., Medigen).
2.
It is possible to take medication before receiving the vaccine.

Reply Date: 2022/02/09

More Info

When considering whether to receive the second dose of the COVID-19 vaccine after experiencing heart-related symptoms following the first dose, it is essential to approach the situation with caution and thorough understanding. Your experience of chest tightness, elevated blood pressure, and anxiety symptoms after the first dose of the BNT vaccine raises valid concerns.
Firstly, it is important to recognize that anxiety can significantly impact physical health, leading to symptoms such as elevated heart rate, chest discomfort, and increased blood pressure. The fact that your symptoms improved after taking prescribed medications suggests that anxiety may have played a substantial role in your post-vaccine experience. However, it is also crucial to rule out any underlying cardiac issues, especially since you have a history of heart-related symptoms.

Given your situation, here are several considerations:
1. Consultation with Healthcare Providers: It is vital to have an open dialogue with your healthcare provider about your symptoms and concerns. They can assess your medical history, current health status, and the potential risks and benefits of receiving the second vaccine dose. If you have not already done so, consider seeking a second opinion from a cardiologist or a specialist in vaccine-related side effects.

2. Evaluation of Symptoms: Since your symptoms were significant enough to warrant an emergency room visit, it is essential to ensure that any underlying cardiac conditions are adequately evaluated. This may include further testing, such as a 24-hour Holter monitor, echocardiogram, or stress tests, to assess your heart's function and response to stress.

3. Timing of the Second Dose: If your healthcare provider deems it safe to proceed with the second dose, they may recommend waiting until your symptoms are fully resolved and your anxiety is better managed. If you are still experiencing significant anxiety, it may be beneficial to address this with your physician, who may suggest therapy or medication adjustments.

4. Alternative Vaccines: If there are concerns about receiving the same vaccine again, you might discuss the possibility of receiving a different vaccine that may have a different side effect profile. Some individuals have successfully switched vaccine brands after experiencing side effects from the first dose.

5. Pre-Medication Considerations: Regarding the use of anxiety medication (like 安柏寧) before or after vaccination, it is crucial to discuss this with your healthcare provider. They can provide guidance on the appropriate timing and dosage to ensure that it does not interfere with the vaccine's efficacy or your overall health.

6. Monitoring After Vaccination: If you decide to proceed with the second dose, ensure that you are monitored closely afterward. This could involve staying at the vaccination site for a longer period to observe any immediate reactions or having a follow-up appointment scheduled shortly after vaccination.

In conclusion, while it is understandable to feel apprehensive about receiving the second dose of the vaccine after experiencing adverse symptoms, thorough communication with your healthcare provider and proper evaluation of your health status can help guide your decision. It is essential to weigh the benefits of vaccination against the risks of potential side effects, especially in the context of your anxiety and heart health. Your health and well-being should always be the priority, and taking the time to make an informed decision is crucial.

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