Abstract
BackgroundMessenger RNA (mRNA) coronavirus disease of 2019 (COVID-19) vaccine are known to cause minor side effects at the injection site and mild global systemic symptoms in first 24–48 h. Recently published case series have reported a possible association between acute myocarditis and COVID-19 vaccination, predominantly in young males.MethodsWe report a case series of 5 young male patients with cardiovascular magnetic resonance (CMR)-confirmed acute myocarditis within 72 h after receiving a dose of an mRNA-based COVID-19 vaccine.ResultsOur case series suggests that myocarditis in this setting is characterized by myocardial edema and late gadolinium enhancement in the lateral wall of the left ventricular (LV) myocardium, reduced global LV longitudinal strain, and preserved LV ejection fraction. All patients in our series remained clinically stable during a relatively short inpatient hospital stay.ConclusionsIn conjunction with other recently published case series and national vaccine safety surveillance data, this case series suggests a possible association between acute myocarditis and COVID-19 vaccination in young males and highlights a potential pattern in accompanying CMR abnormalities.
Highlights
Messenger RNA coronavirus disease of 2019 (COVID-19) vaccine are known to cause minor side effects at the injection site and mild global systemic symptoms in first 24–48 h
We report the patient characteristics, cardiovascular magnetic resonance (CMR) findings, and clinical course of 5 young male patients with acute myocarditis within 72 h after Messenger RNA (mRNA)-based COVID-19 vaccination
Global longitudinal strain (GLS) by Transthoracic echocardiography (TTE) and CMR was normal at − 19.0% and − 19.1% respectively
Summary
Case 2 A 19-year-old male with history of asthma and without any known cardiovascular conditions presented to the emergency department one day after receiving his second dose of the Pfizer COVID-19 vaccine with symptoms of chest pain. Case 3 A 25-year-old male with no known prior health problems presented to the emergency department 3 days after receiving his second dose of the Moderna COVID19 vaccine with chest pain and dyspnea. Case 4 A 37-year-old male with no known health problems presented to the emergency department 2 days after receiving his second dose of the Pfizer COVID-19 vaccine with chest pain radiating to the left arm. A 12-lead ECG showed ST elevations in the lateral leads and ST depression in lead V1 He was taken emergently to the cardiac catheterization laboratory where invasive coronary angiography was negative for obstructive coronary artery disease. Age (years) Gender Body mass index (kg/m2) Coronary artery disease risk factors Cardiac comorbidities Symptoms Chest pain Dyspnea Other
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