COVID-19 mRNA Vaccine Induced Troponinemia - Is the Vaccine a Cardiac Stressor?

Abstract

There have been emerging concerns of myocarditis with Covid-19 vaccines recently which could be from inflammatory or immunogenic response to vaccine components or something else which is yet to be understood. The most common side effects of the vaccine noted in phase three trials were local reactions and few self-remitting systemic reactions. But we cannot overlook the emerging cardiac manifestations associated with COVID-19 vaccine. Here, we report a young healthy male presenting with atypical chest pain found with troponinemia most likely from myopericarditis, three days after his second dose of Pfizer-BNT162b2 vaccine. He was placed on telemetry monitoring and was treated with Aspirin 81 mg, Colchicine 0.6 mg and Ibuprofen. Given his normal body mass index (BMI), renal function, lipids, d-Dimer, transthoracic echocardiogram (TTE), computed tomography angiography (CTA) chest and non-specific findings in electrocardiogram (EKG), and the close temporal relationship of an inflammatory response to his second COVID-19 vaccination dose, we suspect that his cardiac pathology was a result of his response to vaccination and not to underlying atherosclerotic or embolic disease.