Practice pointer: Orthostatic tachycardia after Covid-19 (BMJ, 24 February 2023)

Summary

Patients with Long Covid—defined by the National Institute for Health and Care Excellence (NICE) as signs and symptoms that persist for more than four weeks following acute Covid-19—may present in primary care with symptoms of palpitations (tachycardia) triggered by standing or minimal exertion. These may be accompanied by dizziness, breathlessness, chest pain, sweating, bloating, fatigue and other symptoms which may be caused by a dysfunction of the autonomic nervous system (dysautonomia).

This practice pointer in the BMJ outlines:

• how tachycardia present in patients with Long Covid.
• what clinical assessment should involve.
• how to test for postural orthostatic tachycardia syndrome in primary care.
• drug and non-drug treatments that are available.
• what patients can do for themselves.
• when patients should be referred to a specialist.