@article{ajmcr20251372,
author={{MD, Resha Reya Ganthan and MD, Fadi Yacoub and MD, Asher Gorantla and FHRS, Nidal Isber MD FACC},
title={Autonomic Aftershock; A Case of Post-Covid Dysautonomia},
journal={American Journal of Medical Case Reports},
volume={13},
number={7},
pages={41--45},
year={2025},
url={https://pubs.sciepub.com/ajmcr/13/7/2},
issn={2374-216X},
abstract={The long-term effects following a COVID-19 infection vary widely, with that including inappropriate sinus tachycardia as a manifestation. Herein we report the case of a middle-aged woman with a history significant for a COVID-19 infection 2-years prior, following which she developed brief episodes of palpitations, otherwise controlled with Metoprolol Succinate. She presented to the hospital after a 1-week history of worsening palpitations far worse in severity from prior episodes, associated with shortness of breath and pre-syncope. ECG on admission demonstrated sinus tachycardia with a significantly elevated heart rate. Multiple repeat ECGs demonstrated periods of sinus tachycardia when symptomatic alternating with a normal sinus rhythm when asymptomatic. Continuous telemetry monitoring while inpatient reported similar findings, with no other tachyarrhythmias present. Multiple other diagnostic tests were performed to rule out a more malignant cause of autonomic instability, which ultimately yielded negative results. The patient was however additionally diagnosed with orthostatic hypotension, which posed a potential confounding factor in the steadfast diagnosis of inappropriate sinus tachycardia. This case highlights the multiple simultaneous manifestations of post-covid syndrome with significant symptom overlap, leading to a missed diagnosis.},
doi={10.12691/ajmcr-13-7-2}
publisher={Science and Education Publishing}
}