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Passing out or losing consciousness is called “syncope” and in general has three causes: cardiac, neurological, or other category. The most serious cause is a cardiac arrest which commonly starts with an arrhythmia from from the ventricles called ventricular tachycardia. The rhythm is sufficiently fast where the heart does not have time to fill with blood and so blood pressure drops precipitously and as a result the patient loses consciousness. In adolescents this could be hard to distinguish from a simple fainting spell (vasodepressor syncope) as a result of getting a needle in the arm or a blood draw. Han and coworkers report on a 17 year old girl who passed out after her first injection of the ineffective Pfizer COVID-19 vaccine.
She was hospitalized and found to have COVID-19 vaccine induced myocarditis (with left ventricular dysfunction) and during observation, ventricular tachycardia occurred that self-terminated (non-sustained). She spent over a month in the hospital. If that arrhythmia would have been prolonged a cardiac arrest would have ensued similar to that of so many of the athletes we have seen collapse on the playing field. This is an important paper since myocarditis is not mild nor transient and under direct observation can be manifest as a lethal arrhythmia.
So if someone you know has had palpitations or passed out in conjunction with ill-advised COVID-19 vaccination, be sure to suggest a cardiovascular evaluation. There should be no athletic activity until myocarditis is ruled out.
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Source
Han J, Lee J, Choi S, Lee H, Song YH. Case report: Myocarditis with nonsustained ventricular tachycardia following COVID-19 mRNA vaccination in a female adolescent. Front Pediatr. 2022 Nov 21;10:995167. doi: 10.3389/fped.2022.995167. PMID: 36479288; PMCID: PMC9720276.
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