Post-COVID-19 Postural Orthostatic Tachycardia Syndrome
Yuki Ishibashi, Kihei Yoneyama, Tomoya Tsuchida, Yoshihiro J. Akashi
Abstract
We herein report a 25-year-old woman who developed new-onset postural orthostatic tachycardia syndrome (POTS) following COVID-19 infection without pneumonia. Three weeks after being diagnosed with COVID-19, she began experiencing fatigue, feeing unwell, intermittent palpitation, dyspnea and chest pain, especially while getting up from the sitting position. Her tilt test showed an increase in her heart rate from 80 bpm in the supine position to 110 bpm in the absence of hypotension during a 10-minute head-up tilt at an angle of 90, which returned to the baseline level immediately after lowering to the supine position (Picture A). These measurements fit the criteria of POTS. Of note, her heart rate temporarily decreased after lower limb countermaneuvers were performed (Picture A). We have found lowdose bisoprolol (2.5 mg oral, daily) to be markedly effective in reducing the standing heart rate and improving symptoms acutely (Picture B).