Case Report: Acute myocardial infarction with acute left ventricular failure and acute renal damage following mRNA-1273 vaccination: Possible adverse effect of COVID-19 vaccination?

Abstract

Background: Evaluating potential vaccine side effects is often a prerequisite to combat the coronavirus disease 2019 (COVID-19) pandemic more effectively in a low-resource setting where herd immunity could be the most feasible option. Case report: Here, we present, an 80-year-old man with multiple comorbidities was admitted into the coronary care unit at Ibn Sina Medical College Hospital (Dhaka, Bangladesh) with severe central chest pain and respiratory distress after receiving the first dose of Moderna vaccine on July 26, 2021. On admission, his blood pressure was 110/70 mmHg, pulse 90 beats/min, respiratory rate 22 breaths/min, temperature 36.7°C. He had a vesicular breath sound with bilateral basal crepitations and normal heart sounds. On the ECG, significant changes were observed. Other lab findings were significant troponin-I: 1.72 ng/ml, trace protein and glucose in the urine, total white blood cell count: 12820/cm3; HbA1c, 7.5%; serum creatinine, 1.56 mg/dl; serum electrolytes: sodium 133 mmol/L, chloride 92 mmol/L. The patient had a medical history of prior myocardial infarction, diabetes mellitus, and hypertension but no chronic kidney disease, cerebrovascular disease, or bronchial asthma. After admission, he was treated conservatively with necessary medications and monitored periodically. The patient was diagnosed with acute myocardial infarction with left ventricular failure with acute kidney injury on chronic kidney disease with diabetes mellitus and hypertension. He was discharged from the hospital on day six with proper medicinal support with full recovery. Conclusions: Though acute cardiac complications following COVID-19 vaccines are unusual, this case report can contribute to further molecular research to identify the possible role of vaccine compounds in triggering such complications among the general population.