1887
  1. Home
  2. A-Z Publications
  3. Journal of Emergency Medicine, Trauma and Acute Care
  4. Volume 2023, Issue 4
  5. Article
Volume 2023, Issue 4
  • ISSN: 1999-7086
  • EISSN: 1999-7094

Abstract

The development of messenger ribonucleic acid (mRNA) vaccines has revolutionized the field of preventive medicine. These came into the spotlight during the COVID-19 pandemic. Despite the fact that vaccines are broadly safe, some rare, life-threatening side effects have been reported in the recent past, and myocarditis is one of them. We present a case of COVID-19 mRNA vaccine-induced myocarditis in a young male. Three days after receiving the third dose of the BNT-162b2 mRNA vaccine for COVID-19, he presented to the emergency department after experiencing palpitations. He was admitted to the hospital due to raised cardiac enzymes and a concerning echocardiogram. Magnetic resonance imaging the following day revealed myocarditis. There have been multiple cases of myocarditis reported in the literature owing to the COVID-19 mRNA vaccine. This case stands out because of the presence of regional wall motion anomalies in the echocardiogram, which is an unusual finding in patients with myocarditis. We recommend keeping a low threshold for investigating young patients presenting with cardiovascular symptoms who have received a recent COVID-19 mRNA vaccine.

© 2023 Abd Ur Rehman, Ilyas, Iqbal, Huda, Akram, Mohamed, Al Kuwari, licensee HBKU Press.
Loading

Article metrics loading...

/content/journals/10.5339/jemtac.2023.35
2023-11-28
2024-11-01
Loading full text...

Full text loading...

/deliver/fulltext/jemtac/2023/4/jemtac.2023.35.html?itemId=/content/journals/10.5339/jemtac.2023.35&mimeType=html&fmt=ahah

References

  1. World Health Organization. WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020. Geneva: World Health Organization; 2020.
     [Google Scholar]
  2. World Health Organization. Weekly epidemiological update on COVID-19. Geneva: World Health Organization; 2022.
     [Google Scholar]
  3. BBC NEWS. Covid-19 vaccine: First person receives Pfizer jab in UK. London: BBC NEWS; 2020.
     [Google Scholar]
  4. Centers for Disease Control and Prevention. Selected adverse events reported after COVID-19 vaccination. Atlanta, GA: Centers for Disease Control and Prevention; 2023.
     [Google Scholar]
  5. Yasmin F, Najeeb H, Naeem U, Moeed A, Atif AR, Asghar MS, et al. Adverse events following COVID-19 mRNA vaccines: a systematic review of cardiovascular complication, thrombosis, and thrombocytopenia. Immun Inflamm Dis. 2023; 11:(3):e807. doi: [Crossref]
     https://doi.org/10.1002/iid3.807 [Google Scholar]
  6. Fu M, Kontogeorgos S, Thunström E, Zverkova Sandström T, Kroon C, Bollano E, et al . Trends in myocarditis incidence, complications and mortality in Sweden from 2000 to 2014. Sci Rep. 2022; 12:(1):1810. doi: [Crossref]
     https://doi.org/10.1038/s41598-022-05951-z [Google Scholar]
  7. Cevik M, Kuppalli K, Kindrachuk J, Peiris M. Virology, transmission, and pathogenesis of SARS-CoV-2. BMJ. 2020; 371::m3862. doi: [Crossref]
     https://doi.org/10.1136/bmj.m3862 [Google Scholar]
  8. Wadhwa A, Aljabbari A, Lokras A, Foged C, Thakur A. Opportunities and challenges in the delivery of mRNA-based vaccines. Pharmaceutics. 2020; 12:(2):102. doi: [Crossref]
     https://doi.org/10.3390/pharmaceutics12020102 [Google Scholar]
  9. Mascellino MT, Di Timoteo F, De Angelis M, Oliva A. Overview of the main anti-SARS-CoV-2 vaccines: mechanism of action, efficacy and safety. Infect Drug Resist. 2021; 14::3459–76. doi: [Crossref]
     https://doi.org/10.2147/IDR.S315727 [Google Scholar]
  10. Basta NE, Moodie EMM on behalf of the VIPER (Vaccines, Infectious disease Prevention, and Epidemiology Research) Group COVID-19 Vaccine Development and Approvals Tracker Team. COVID-19 vaccine development and approvals tracker. Dallas, TX: VIPER Press; 2020.
     [Google Scholar]
  11. Rosa SS, Prazeres DMF, Azevedo AM, Marques MPC. mRNA vaccines manufacturing: challenges and bottlenecks. Vaccine. 2021; 39:(16):2190–200. doi: [Crossref]
     https://doi.org/10.1016/j.vaccine.2021.03.038 [Google Scholar]
  12. Oster ME, Shay DK, Su JR, Gee J, Creech CB, Broder KR, et al. Myocarditis cases reported after mRNA-based COVID-19 vaccination in the US from December 2020 to August 2021. JAMA. 2022; 327:(4):331-340. doi: [Crossref]
     https://doi.org/10.1001/jama.2021.24110 [Google Scholar]
  13. Patone M, Mei XW, Handunnetthi L, Dixon S, Zaccardi F, Shankar-Hari M, et al. Risks of myocarditis, pericarditis, and cardiac arrhythmias associated with COVID-19 vaccination or SARS-CoV-2 infection. Nat Med. 28::410–422 (2022). doi: [Crossref]
     https://doi.org/10.1038/s41591-021-01630-0 [Google Scholar]
  14. Husby A, Hansen JV, Fosbøl E, Thiesson EM, Madsen M, Thomsen RW, et al. SARS-CoV-2 vaccination and myocarditis or myopericarditis: population based cohort study. BMJ. 2021; 375::e068665. doi: [Crossref]
     https://doi.org/10.1136/bmj-2021-068665 [Google Scholar]
  15. Karlstad Ø, Hovi P, Husby A, Härkänen T, Selmer RM, Pihlström N, et al. SARS-CoV-2 vaccination and myocarditis in a Nordic cohort study of 23 million residents. JAMA Cardiol. 2022; 7:(6):600–12. doi: [Crossref]
     https://doi.org/10.1001/jamacardio.2022.0583 [Google Scholar]
  16. Straus W, Urdaneta V, Esposito DB, Mansi JA, Sanz Rodriguez C, Burton P, et al. Analysis of myocarditis among 252 million mRNA-1273 recipients worldwide. Clin Infect Dis. 2023; 76:(3):e544–552. doi: [Crossref]
     https://doi.org/10.1093/cid/ciac446 [Google Scholar]
  17. Pinamonti B, Alberti E, Cigalotto A, Dreas L, Salvi A, Silvestri F, et al. Echocardiographic findings in myocarditis. Am J Cardiol. 1988; 62:(4):285–91. doi: [Crossref]
     https://doi.org/10.1016/0002-9149(88)90226-3 [Google Scholar]
  18. Leitman M, Tyomkin V, Peleg E, Copel L, Vered Z; FACC, FESC. Left ventricular function in acute inflammatory peri-myocardial diseases – new insights and long-term follow-up. Cardiovasc Ultrasound. 2012; 10::42. doi: [Crossref]
     https://doi.org/10.1186/1476-7120-10-42 [Google Scholar]
  19. Caforio AL, Pankuweit S, Arbustini E, Basso C, Gimeno-Blanes J, Felix SB, et al. Current state of knowledge on aetiology, diagnosis, management, and therapy of myocarditis: a position statement of the European Society of Cardiology Working Group on Myocardial and Pericardial Diseases. Eur Heart J. 2013; 34:(33):2636–48d. doi: [Crossref]
     https://doi.org/10.1093/eurheartj/eht210 [Google Scholar]
  20. Siripanthong B, Nazarian S, Muser D, Deo R, Santangeli P, Khanji MY, et al. Recognizing COVID-19-related myocarditis: the possible pathophysiology and proposed guideline for diagnosis and management. Heart Rhythm. 2020; 17:(9):1463–71. doi: [Crossref]
     https://doi.org/10.1016/j.hrthm.2020.05.001 [Google Scholar]
  21. Truong DT, Dionne A, Muniz JC, McHugh KE, Portman MA, Lambert LM, et al. Clinically suspected myocarditis temporally related to COVID-19 vaccination in adolescents and young adults: suspected myocarditis after COVID-19 vaccination. Circulation. 2022; 145:(5):345–56. doi: [Crossref]
     https://doi.org/10.1161/CIRCULATIONAHA.121.056583 [Google Scholar]
  22. Sun ML, Yang JM, Sun YP, Su GH. [Inhibitors of RAS might be a good choice for the therapy of COVID-19 pneumonia]. Zhonghua Jie He He Hu Xi Za Zhi. 2020; 43:(3):219−22. doi: [Crossref]
     https://doi.org/10.3760/cma.j.issn.1001-0939.2020.03.016 [Google Scholar]
  23. Ferrario CM, Jessup J, Chappell MC, Averill DB, Brosnihan KB, Tallant EA, et al. Effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockers on cardiac angiotensin-converting enzyme 2. Circulation. 2005; 111:(20):2605–10. doi: [Crossref]
     https://doi.org/10.1161/CIRCULATIONAHA.104.510461 [Google Scholar]
  24. Bozkurt B, Kovacs R, Harrington B. Joint HFSA/ACC/AHA statement addresses concerns re: using RAAS Antagonists in COVID-19. J Card Fail. 2020; 26:(5):370. doi: [Crossref]
     https://doi.org/10.1016/j.cardfail.2020.04.013 [Google Scholar]
  25. Kociol RD, Cooper LT, Fang JC, Moslehi JJ, Pang PS, Sabe, MA, et al. Recognition and initial management of fulminant myocarditis: a scientific statement from the American Heart Association. Circulation. 2020; 141:(6):e69–92. doi: [Crossref]
     https://doi.org/10.1161/CIR.0000000000000745 [Google Scholar]
/content/journals/10.5339/jemtac.2023.35
Loading
Rare presentation of COVID-19 vaccine-induced myocarditis: A case report
Journal of Emergency Medicine, Trauma and Acute Care 2023, 35 (2023); https://doi.org/10.5339/jemtac.2023.35
/content/journals/10.5339/jemtac.2023.35
/content/journals/10.5339/jemtac.2023.35
Loading

Data & Media loading...

Keyword(s): COVID-19, mRNA vaccine and myocarditis

Most Cited Most Cited RSS feed

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error