Heart Palpitations After COVID-19 Vaccination: Causes and Solutions

Arrhythmia

Since receiving my second dose of the BNT vaccine, I have started to experience occasional palpitations, arrhythmia, and general discomfort.
The day after the vaccination, I felt significant discomfort in my heart, which, combined with anxiety, led to hyperventilation.
I called an ambulance and went to the emergency room.
After calming down, I checked my blood pressure and heart rate, and had blood tests, all of which came back normal.
The following day, I felt unwell again and returned to the emergency room.
The doctor, concerned about my anxiety, admitted me for observation.
During my stay, I underwent several tests, including echocardiograms, electrocardiograms, and multiple blood tests.
Aside from mild mitral valve prolapse and some heart contraction issues possibly related to the vaccine, everything else was fine.
The doctor assured me that this would improve and scheduled a follow-up appointment for medication.
During the period leading up to my medication pickup, my emotions were somewhat unstable, causing various discomforts.
However, after starting the medication, my heart felt better, although I still experienced some tension and anxiety.
For two weeks after finishing the medication, I did not have any significant heart issues.
Then, the week before the Lunar New Year, I experienced palpitations again, with my heart rate jumping to the 90s, while it usually stays in the 70s to 80s.
I suspected it might be related to my menstrual cycle, so I had a pelvic ultrasound, which showed no issues.
After returning home, I took some anti-arrhythmic medication my father gave me, which helped significantly.

After the New Year, I visited another clinic for a cardiac evaluation and had another echocardiogram, where the doctor confirmed that my heart was healthy.
The doctor prescribed medication for palpitations and an anti-anxiety medication to take at bedtime.
After taking these, I felt much better, but I only take the palpitations medication in the morning and evening.
Recently, for the past two to three days, I have been feeling my heart skip a beat in the afternoon, accompanied by mild abdominal pain, pain in my left arm, and discomfort in my left back, all of which are quite mild and more of an achy sensation.
I am unsure what is causing this, as it does not occur at night.
Additionally, I experienced a brief sensation of coolness on the left side of my occipital region while lying down, lasting only a minute or two.
I also often feel a cool sensation on the left side of my face when I sneeze, which lasts about a minute.
1.
I would like to know if these recent issues could be side effects of the medication?
2.
What are other possible causes of my arrhythmia? (I maintain a regular schedule, going to bed around 10 or 11 PM and waking up at 6 or 7 AM, but I often dream.
I do not consume coffee or alcohol, do not smoke, mostly drink warm water, and avoid spicy foods.)

Xiao Zhu, 10~19 year old female. Ask Date: 2022/02/14

Dr. Liao Yaopan reply Family Medicine

Hello, based on your description, if all cardiac-related examinations have been completed and no significant abnormalities were found, the aforementioned subjective symptoms may not be of cardiac origin.
However, it is still important to monitor the situation.
If the symptoms persist, it is advisable to have a family member accompany you to seek medical attention, and to have a cardiologist follow up for further evaluation.
Self-medication is not recommended.
Additionally, engaging in moderate exercise, maintaining a regular routine, and keeping a positive mindset can help alleviate feelings of anxiety.
Please note: online consultations are not equivalent to in-person visits and cannot provide diagnoses or treatment recommendations.
Changhua Hospital cares about you.

Reply Date: 2022/02/14

More Info

Understanding heart palpitations and other cardiovascular symptoms after receiving a COVID-19 vaccine, such as the BNT vaccine, can be complex. It is essential to consider various factors, including pre-existing conditions, the body's response to the vaccine, and psychological aspects like anxiety.

From your description, it seems that you experienced significant discomfort shortly after your vaccination, leading to multiple visits to the emergency department. The tests, including echocardiograms and blood tests, returned normal results, except for a mild mitral valve prolapse. This condition is relatively common and often does not lead to serious complications. However, it can sometimes contribute to palpitations or a feeling of an irregular heartbeat, especially in the context of stress or anxiety.

The symptoms you described, such as palpitations, chest discomfort, and feelings of anxiety, can be exacerbated by the stress of the vaccination experience itself. The body's response to stress can lead to hyperventilation, which may cause feelings of lightheadedness, tingling, or even chest pain. It is also possible that the vaccine triggered a temporary increase in anxiety levels, which can lead to a cycle of worry about your heart health, further exacerbating your symptoms.

1. Medication Side Effects: Regarding your question about whether your recent symptoms could be side effects of the medication you were prescribed, it is essential to consult with your healthcare provider. Some medications, particularly those used for anxiety or heart rhythm issues, can have side effects that include palpitations or gastrointestinal discomfort. If you suspect that your medication may be contributing to your symptoms, it is crucial to discuss this with your doctor, who can evaluate your situation and possibly adjust your treatment plan.

2. Other Possible Causes of Palpitations: Heart palpitations can arise from various factors, including:
- Anxiety and Stress: As mentioned, anxiety can significantly impact heart rhythm and lead to palpitations. Techniques such as mindfulness, deep breathing exercises, and cognitive behavioral therapy can help manage anxiety.

- Hormonal Changes: If you are experiencing these symptoms around your menstrual cycle, hormonal fluctuations could also play a role in your symptoms.

- Electrolyte Imbalances: Sometimes, imbalances in electrolytes (like potassium or magnesium) can lead to palpitations. Ensuring a balanced diet can help mitigate this risk.

- Physical Activity: While you mentioned having a regular sleep schedule, any changes in physical activity levels or stress from daily life can also contribute to palpitations.

Given your symptoms, including the left arm and back pain, it is essential to monitor these closely. While they may be related to anxiety or muscle strain, any persistent or severe symptoms should be evaluated by a healthcare professional to rule out any serious conditions.

In summary, while your symptoms may be related to anxiety and the body's response to the vaccine, it is crucial to maintain open communication with your healthcare provider. They can help you navigate your symptoms, adjust medications if necessary, and provide reassurance. If your symptoms persist or worsen, further evaluation may be warranted to ensure your heart health remains stable. Regular follow-ups and possibly seeing a cardiologist or a specialist in anxiety management could provide additional support and clarity regarding your condition.

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