Acute Myocarditis After COVID-19 Vaccination.

Abstract

https://e-heartfailure.org A healthy 20-year-old man presented with chest pain one day after receiving the second dose of mRNA-1273 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination (Moderna®) and came to the emergency room. He also received 1st coronavirus disease 2019 (COVID-19) vaccination which was the same vaccine 1 month before and had no side effects at that time. However, he experienced chest discomfort, nausea, and dyspnea on the night of 2nd injection. When the patient arrived at the emergency room, blood pressure was 107/74 mmHg, pulse rate 85/min, respiratory rate 20/min, body temperature 37.0°C, and peripheral oxygen saturation 96%. The electrocardiography showed the entire lead ST elevation except lead III. Blood tests revealed neutrophil dominant leukocytosis (18.9×103/μL), elevated levels of cardiac markers such as creatine kinase MB (CK-MB), troponin I (TnI), N-terminal pro-brain natriuretic peptide (51.0 ng/mL, 5.12 ng/mL, and 752 pg/mL respectively) and elevated inflammatory marker C-reactive protein (CRP) level to 260.7mg/L. The patient’s COVID-19 polymerase chain reaction was negative. Also, enterovirus, adenovirus, and tests through other nasopharyngeal viral panels, and differential tests for parvovirus, human herpesvirus type 6, cytomegalovirus, and Epstein-Barr virus through serum were conducted when the patient admitted, and confirmed as all negative. Even though he was young, chest pain with ST-elevation on electrocardiogram and elevation of cardiac marker cannot rule out acute myocardial infarction, we urgently underwent coronary angiography and the result was negative.