Palpitations After COVID-19 Vaccination: A Cardiovascular Perspective - Cardiology

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Palpitations following COVID-19 vaccination can be concerning, especially for individuals with pre-existing conditions such as hypertension and obesity. Your symptoms of palpitations, accompanied by feelings of fear, cold extremities, and elevated blood pressure, warrant careful consideration and further evaluation.

Firstly, it is important to understand that palpitations can arise from various causes, including anxiety, stress, or physiological responses to vaccination. Vaccines, including the BNT (BioNTech) vaccine, can trigger an immune response, which may lead to transient changes in heart rate and rhythm. This is generally considered a benign reaction, especially if the symptoms resolve quickly and do not recur frequently.

Your experience of palpitations occurring intermittently, particularly in the evening, could be related to several factors. Stress and anxiety can exacerbate the perception of palpitations, and given the context of receiving a vaccine, it is not uncommon for individuals to experience heightened anxiety about potential side effects. Additionally, your history of hypertension and being overweight may contribute to cardiovascular sensitivity, making you more aware of your heart's activity.

The fact that you have undergone an electrocardiogram (ECG) that returned normal results is reassuring. Normal ECG findings suggest that there is no immediate evidence of significant arrhythmias or acute cardiac events. The elevated high-sensitivity cardiac troponin I levels you mentioned (49.600 pg/ml) could indicate some degree of myocardial stress or injury, but the subsequent decrease to 45.100 pg/ml is a positive sign, suggesting that the situation may be stabilizing.

Given your ongoing symptoms and the fact that you are awaiting results from a 24-hour Holter monitor, echocardiogram, and cardiac CT, it is prudent to continue monitoring your condition closely. These tests will provide valuable information about your heart's function and structure, helping to rule out any underlying issues such as coronary artery disease or structural heart problems.

As for the possibility of vaccine-related cardiac issues, while there have been rare reports of myocarditis and pericarditis following mRNA vaccinations, these conditions typically present with more severe symptoms, such as persistent chest pain, shortness of breath, or significant arrhythmias. Your symptoms, while concerning, do not strongly align with these conditions based on the information provided.

In the meantime, it may be beneficial to manage your anxiety and stress levels, as these can significantly impact your perception of palpitations. Techniques such as deep breathing exercises, mindfulness, and relaxation strategies may help alleviate some of the anxiety associated with your symptoms.

In conclusion, while your symptoms warrant further investigation, the current evidence suggests that the likelihood of significant cardiac issues related to the vaccine is low, especially given your normal ECG results. It is essential to follow up with your healthcare provider to discuss the results of your ongoing tests and to develop a comprehensive management plan tailored to your specific needs. If your symptoms persist or worsen, do not hesitate to seek immediate medical attention.