Heart Palpitations and Chest Pain After Vaccination

Chest pain and palpitations?

In the past, I had a habit of exercising.
After receiving my second dose of the Moderna vaccine in May of this year, I experienced palpitations (heart rate of 130-140) and had to visit the emergency room several times.
However, all cardiac tests came back normal.
After several months, the palpitations have finally eased somewhat, but since then, I have been unable to exercise, as even climbing stairs leaves me breathless.

In the past two weeks, I have experienced intermittent sharp pain on the left side of my chest, which lasts only a few seconds but occurs multiple times throughout the day.
Sometimes, while sitting or lying down, my heart rate suddenly increases (110-120), and I can feel my heart pounding strongly in my ears and head.
Occasionally, I also feel a skipped heartbeat, followed by a tingling sensation in my heart, and then my hands and feet become numb.
My legs sometimes feel weak, making it difficult to walk.

For several consecutive days, I have experienced dizziness, headaches, diarrhea, and unusual fatigue (feeling like I could fall asleep or faint at any moment).
However, my daily routine has not changed significantly.
Due to the multitude of symptoms, I am unsure which specialist to consult.
Could this be an issue related to the autonomic nervous system, or is there a real problem with my heart?

Mia, 30~39 year old female. Ask Date: 2022/11/19

Dr. Peng Shiwei reply Neurology

Hello, it is indeed possible to experience palpitations after receiving the Moderna vaccine, but they typically do not last for an extended period.
If your symptoms persist and other symptoms begin to appear, it is advisable to consult a cardiologist to rule out any heart-related issues.
If your heart is found to be normal, your physician can then refer you to other specialists for further evaluation.

Reply Date: 2022/11/19

More Info

Your symptoms following the Moderna vaccine raise important questions regarding potential cardiovascular effects, particularly in the context of heart palpitations and chest pain. It's understandable to feel concerned, especially given your history of exercise and the sudden onset of these symptoms.

Firstly, it's essential to recognize that vaccines, including mRNA vaccines like Moderna, can elicit various immune responses. While serious cardiovascular complications such as myocarditis and pericarditis have been reported, particularly in younger males after mRNA vaccination, these occurrences are relatively rare. The symptoms you describe—palpitations, chest pain, and episodes of rapid heart rate—can indeed be alarming, but they do not necessarily indicate a direct vaccine-related complication.

Your experience of heart palpitations (with rates of 130-140 bpm) and episodes of chest pain, particularly if they are transient, could be attributed to several factors. Anxiety and stress, especially following a health scare or concerning symptoms, can significantly impact heart rate and lead to sensations of palpitations. Additionally, post-viral syndromes or vaccine-related immune responses may also contribute to autonomic nervous system dysregulation, which can manifest as palpitations, dizziness, and fatigue.

The presence of symptoms such as shortness of breath with exertion (like climbing stairs), chest pain, and episodes of dizziness and fatigue warrants a thorough evaluation. While your previous cardiac assessments may have returned normal results, it is crucial to consider that symptoms can evolve over time. The autonomic nervous system, which regulates heart rate and blood pressure, can become imbalanced, leading to symptoms like those you describe.

Given the complexity of your symptoms, it would be prudent to consult with a cardiologist who specializes in arrhythmias or autonomic disorders. They can perform a comprehensive evaluation, which may include:
1. Holter Monitoring: This 24-hour ECG monitoring can help capture any arrhythmias or abnormal heart rates that may not have been evident during previous tests.

2. Echocardiogram: An ultrasound of the heart can assess its structure and function, ensuring there are no underlying issues contributing to your symptoms.

3. Stress Testing: This can evaluate how your heart responds to physical exertion and help identify any ischemic changes or arrhythmias.

4. Autonomic Testing: If autonomic dysfunction is suspected, specialized tests can assess how well your autonomic nervous system is functioning.

In addition to these evaluations, it may be beneficial to explore lifestyle modifications that can help manage symptoms, such as stress reduction techniques, hydration, and a gradual return to physical activity as tolerated.
Lastly, it’s essential to maintain open communication with your healthcare provider about your symptoms and any changes you experience. Keeping a symptom diary can also be helpful in identifying triggers or patterns related to your symptoms.
In summary, while your symptoms are concerning, they may not necessarily indicate a severe underlying cardiac issue. A thorough evaluation by a specialist will provide clarity and help guide appropriate management strategies.

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