Subscribe to RSS
DOI: 10.1055/s-0042-1758218
Post-COVID-19 Inappropriate Sinus Tachycardia Treated with Naja tripudians: A Case Report

Abstract
Background/Introduction The majority of people who recover from coronavirus disease 2019 (COVID-19) experience tachycardia and/or palpitations after slight activity or at rest. In some cases, the resting heart rate may remain above 100 beats per minute or get exacerbated out of proportion by slight activity. This persistent tachycardia appearing in post-COVID-19 may clinically present as inappropriate sinus tachycardia (IST). The common mode of diagnosis is electrocardiography after excluding other causes of tachycardia. So far, there is no reported study evaluating individualised homoeopathic intervention in post-COVID-19 IST in peer-reviewed homoeopathic journals.
Method This report describes a case of tachycardia and palpitations developed after COVID-19. After complete evaluation of laboratory reports and clinical examination, the diagnosis of IST was made. After detailed case taking and repertorisation, Naja tripudians was prescribed as an individualised homoeopathic remedy to treat the case. Outcomes were assessed objectively on the basis of electrocardiography and subjectively using outcome related to impact on daily living (ORIDL) scale.
Result There was a marked subjective improvement along with objective improvement as evidenced by electrocardiography images. The case showed a 4+ outcome on ORIDL scale. The Modified Naranjo Criteria total score was +9 out of a possible +13, providing definite evidence to attribute the clinical outcome with the homoeopathic intervention.
Conclusion This single case demonstrates that Naja tripudians, a rarely used drug, may be helpful in treating post-COVID-19 IST. Clinical trials in this direction are required to conclude firm causal attribution.
Consent
The patient gave informed consent to have his case published.
Authors' Contributions
A.A. was involved in case recording, case diagnosis, literature research, appropriate remedy selection for case and drafting the paper; U.K. contributed to opinion regarding investigations, opinion regarding appropriate remedy selection for case, drafting the paper; D.K.S. provided opinion regarding investigations, drafting the paper.
Publication History
Article published online:
31 March 2023
© 2023. Thieme. All rights reserved.
Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India
-
References
- 1 Centres for Disease Control and Prevention. Long Covid or Post Covid complications [Internet]. 2020 [Cited 2022 May 7]. Accessed October 11, 2022, at: https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html
- 2 Augustin M, Schommers P, Stecher M. et al. Post-COVID syndrome in non-hospitalised patients with COVID-19: a longitudinal prospective cohort study. Lancet Reg Health Eur 2021;6(100122): 100122 https://www.sciencedirect.com/science/article/pii/S2666776221000995?via%3Dihub Cited 2021Aug17 10.1016/j.lanepe.2021.100122 [Internet]
- 3 Raveendran AV, Jayadevan R, Sashidharan S. Long COVID: an overview. Diabetes Metab Syndr 2021; 15 (03) 869-875
- 4 Greenhalgh T, Knight M, A'Court C, Buxton M, Husain L. Management of post-acute covid-19 in primary care. BMJ 2020; 370: m3026 https://www.bmj.com/content/370/bmj.m3026 Cited 2021Aug17 10.1136/bmj.m3026 [Internet]
- 5 Ho JS, Tambyah PA, Ho AF, Chan MY, Sia CH. Effect of coronavirus infection on the human heart: a scoping review. Eur J Prev Cardiol 2020; 27 (11) 1136-1148
- 6 Ståhlberg M, Reistam U, Fedorowski A. et al. Post Covid-19 tachycardia syndrome: a distinct phenotype of post acute Covid-19 syndrome. Am J Med 2021; 134 (12) 1451-1456 https://www.amjmed.com/article/S0002-9343(21)00472-1/fulltext Cited 2021Aug30 10.1016/j.amjmed.2021.07.004 [Internet]
- 7 Arano Llach J, Victor Bazan VBG, Gemma Llados GLL. et al. Inappropriate sinus tachycardia in post post-covid-19 syndrome. Europace 2021; 23 (03) 116
- 8 Desai AD, Boursiquot BC, Melki L, Wan EY. Management of arrhythmias associated with COVID-19. Curr Cardiol Rep 2020; 23 (01) 2 https://pubmed.ncbi.nlm.nih.gov/33231782/ Cited 2021Aug30 10.1007/s11886-020-01434-7 [Internet]
- 9 Sawalha K, Habash F, Vallurupalli S, Paydak H. Inappropriate sinus tachycardia following viral illness. Clin Pract 2021; 11 (02) 219-222
- 10 Ruzieh M, Moustafa A, Sabbagh E, Karim MM, Karim S. Challenges in treatment of inappropriate sinus tachycardia. Curr Cardiol Rev 2018; 14 (01) 42-44
- 11 Olshansky B, Sullivan RM. Inappropriate sinus tachycardia. Europace 2019; 21 (02) 194-207
- 12 Frysh B. Inappropriate sinus tachycardia. WebMD [Internet]. 2020 [Cited 2021 Aug 30]. Accessed October 11, 2022, at: https://www.webmd.com/heart-disease/inappropriate-sinus-tachycardia
- 13 Hompath Zomeo trial 3.0 software.
- 14 Homeopathe International. The encyclopedia of pure materia medica by Timothy F Allen [Internet]. [Cited 2021 Aug 31]. Accessed October 11, 2022, at: http://www.homeoint.org/allen/n/naja.htm
- 15 Homeopathe International. Handbook of material medica and Homoeopathic therapeutics by T F Allen [Internet]. [Cited 2021 Aug 31]. Accessed October 11, 2022, at: http://www.homeoint.org/books1/allenhandbook/n/naja.htm
- 16 Kent JT. Lectures on Homoeopathic Philosophy. Ed. New Delhi: Pratap Medical Publishers Pvt Ltd; 1994: 655-658
- 17 Clarke JH. A Dictionary of Practical Material Medica. Ed. New Delhi: B. Jain Publishers (P) Ltd; 2006: 523-529
- 18 Homeopathe International. The guiding symptoms of our materia medica by C Hering [Internet]. [Cited 2021 Aug 31]. Accessed October 11, 2022, at: http://homeoint.org/hering/index.htm
- 19 Boericke W. Pocket Manual of Homoeopathic Materia Medica with Indian Medicine and Repertory. 9th edition.. New Delhi: Indian Book and Periodical Publishers; 2002
- 20 Reilly D, Mercer SW, Bikker AP, Harrison T. Outcome related to impact on daily living: preliminary validation of the ORIDL instrument. BMC Health Serv Res 2007; 7: 139
- 21 WHOQOL. Measuring quality of life. World Health Organisation [Cited 2021 August 17]. Accessed October 11, 2022, at: https://www.who.int/tools/whoqol/whoqol-bref/docs/default-source/publishing-policies/whoqol-bref/english-australian-whoqol-bref
- 22 Hahnemann S. Organon of Medicine. 6th edition.. New Delhi: B. Jain Publishers (P) Ltd; 2002: 203
- 23 Lamba CD, Gupta VK, van Haselen R. et al. Evaluation of the Modified Naranjo Criteria for assessing causal attribution of clinical outcome to homoeopathic intervention as presented in case reports. Homeopathy 2020; 109 (04) 191-197