Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Medical diet, Orthostatic hypotension, Presyncope, Sinus tachycardia, Syncope
Clinical narrative: The morning after receiving the Moderna COVID-19 vaccine I woke up with severe dizziness and near-syncope upon standing.  I made an appointment to see my Primary Care Doctor and had an appointment scheduled for February 11, 2022. Dr decided to do vitals, blood work, EKG and exam. My blood pressure lying was 98/60 lying and 130/80 standing with associated dizziness. My EKG showed Sinus Tachycardia with Nonspecific ST depression and Diffuse nonspecific T-abnormalities. Dr decided to start me on a high sodium diet with increased fluid intake. On Monday February 14, 2022 I followed up with Dr and I had less dizziness complaints over the weekend.  Dr advised me that I had a severe iron deficiency anemia and recommended starting on an Iron supplement and Vitamin C supplement. He also recommended follow-up with Dr MD, a Cardiologist. I had an appointment with Dr on Monday February 21st, 2022. I went to work as an Emergency Room Registered Nurse and felt Chest Pain on February 17, 2022, so I was admitted to the hospital under Observation Status. I was discharged the same day. I advised Dr of my hospital stay and he wanted me to follow with the Cardiologist. I saw Dr on 2/21/22 and he performed vital signs which showed orthostatic hypotension, an EKG which was abnormal and a one-week Holter monitor. After returning the Holter monitor, Dr called to inform me that I had episodes of severe tachycardia shown on the Holter and I should see Dr MD, an electrophysiologist. I made an appointment with Dr on March 16, 2022. I also returned to a follow up appointment with my PCP who started me on Midodrine 2.5mg three times a day for the orthostatic hypotension. I then saw Dr  who had looked over my Holter monitor and advised that I had atrial tachycardia, and he recommended a Cardiac Ablation. I followed up with Dr again on April 5th, 2022 who advised me my iron levels had returned to normal and to increase Midodrine to 5mg three times a day. I underwent an Electrophysiology Study and a successful Cardiac Ablation on April 19, 2022 at Hospital and had to stay overnight. Following the procedure, I continued to have orthostatic hypotension and associated dizziness. I followed up with Dr on Monday May 9, 2022, who I advised of my continuing symptoms, so he had me do an event monitor for a month. I returned to my PCP on May 2, 2022 who advised me to start Fludrocortisone 0.1mg once a day, increase Midodrine to 10mg three times a day, and to follow with a nephrologist, Dr.  D.O. I saw Dr. on May 12, 2022 who advised to start eating small meals throughout the day. I saw Dr again on June 15, 2022. He explained the monitor showed no abnormalities, so my ablation was successful, so he suggested follow-up with my PCP Dr. I finally returned to work due to running out of disability time on Friday June 17, 2002, after having been out on medical leave since February 17, 2022. I saw Dr again on July 25, 2022 for a follow-up. I have since continued to the current date, the Florinef 0.1mg and Midodrine 10mg three times a day and still have episodes of dizziness upon standing along with a number of syncopal episodes. The events following my vaccine administration has changed my ability to work, as I am unable to stand quickly or to stand for long periods of time as a Registered Nurse. It also impacts my daily life, as I feel dizzy often, fear passing out and now have heat intolerance.