From the Guidelines
COVID-19 vaccines are not associated with a significant increased risk of serious cardiac complications, including increased heart rate, and the benefits of vaccination far outweigh the risks. According to the 2022 ACC expert consensus decision pathway on cardiovascular sequelae of COVID-19 in adults 1, myocarditis following COVID-19 mRNA vaccination is rare, with the highest observed rates in young male individuals after the second vaccine dose. The study emphasizes that COVID-19 vaccination has a very favorable benefit-to-risk ratio for all age and sex groups evaluated thus far.
Some key points to consider when evaluating the risk of increased heart rate after COVID-19 vaccination include:
- Myocarditis is defined by cardiac symptoms, elevated cTn, and abnormal electrocardiographic, echocardiographic, CMR, and/or histopathologic findings on biopsy or postmortem evaluation in the absence of flow-limiting coronary artery disease 1.
- Initial testing for suspected cardiac involvement with COVID-19 should consist of an ECG, measurement of cTn, and an echocardiogram 1.
- Cardiology consultation is recommended for those with a rising cTn and/or ECG or echocardiographic abnormalities concerning for myocarditis 1.
- Vaccine-associated myocarditis should be diagnosed, categorized, and treated in a manner analogous to myocarditis following SARS-CoV-2 infection 1.
It is essential to note that while COVID-19 vaccines can cause mild side effects, including temporary increases in heart rate, these effects are typically short-lived and resolve on their own within a few days. If you experience severe or persistent symptoms, you should contact your healthcare provider for further evaluation and guidance. Overall, the available evidence suggests that the benefits of COVID-19 vaccination in preventing severe illness and death from COVID-19 outweigh the risks of rare cardiac complications, including increased heart rate 1.
From the Research
Cardiovascular Complications of COVID-19 Vaccines
- The COVID-19 vaccines have been associated with various cardiovascular complications, including myocarditis, pericarditis, and stress cardiomyopathy 2, 3, 4.
- Myocarditis is the most commonly reported adverse cardiac event associated with mRNA COVID-19 vaccines, presenting as chest pain with a rise in cardiac biomarkers 3.
- The majority of patients with myocarditis are young males, with a median age of 21 years, and most have received the second dose of the vaccine 3.
- Cardiovascular complications after COVID-19 vaccination also include myopericarditis, ischemic heart disease, and arrhythmia 4.
Increased Heart Rate and COVID-19 Vaccines
- There is limited direct evidence on the association between COVID-19 vaccines and increased heart rate.
- However, some studies have reported cases of arrhythmia and isolated tachycardia following immunization with mRNA COVID-19 vaccines 3, 4.
- A systematic review and Bayesian multivariate meta-analysis found no increased risk of arrhythmia post-COVID-19 vaccination 5.
Mechanisms and Risk Factors
- The spike protein produced by the COVID-19 vaccines may have biologic actions that contribute to cardiovascular complications, including damage to endothelial cells and disruption of the blood-brain barrier 6.
- Young males may be more vulnerable to myocarditis after COVID-19 vaccination 4.
- The risk of coronary artery disease may be associated with COVID-19 vaccination, particularly after the second dose of the BNT162b2 vaccine 5.