Myocarditis After SARS-CoV-2 Vaccination: A Vaccine-Induced Reaction?

Abstract

Vaccination plays an important role in the fight against SARS-CoV-2 to minimie the spread of coronavirus disease 2019 (COVID-19) and its life-threatening complications. Myocarditis has been reported as a possible and rare adverse consequence of different vaccines, and its clinical presentation can range from influenza-like symptoms to acute heart failure. We report a case of a 30-year-old man who presented progressive dyspnea and constrictive retrosternal pain after receiving SARS-CoV-2 vaccine. Cardiac magnetic resonance and laboratory data revealed typical findings of acute myopericarditis.

Figure 1

Graph showing the patient's serum levels of cardiac troponin I, creatine kinase-MB, and C-reactive protein during the first 72 hours after hospital admission.

Figure 2

(A, B) Twelve-lead electrocardiography on admission showing subtle ST-segment elevation suggestive of potential myocardial injury or pericarditis in V2-V4 and nonspecific T-wave changes in V5 and V6. (C) Cardiac magnetic resonance imaging T2-weighted short tau inversion recovery sequence acquired along the basal short-axis view shows increased subepicardial signal intensity of the inferolateral myocardial segments (arrows). Increased thickness and signal intensity of pericardium is also shown (arrowheads). T1-weighted phase-sensitive inversion recovery sequences performed along (D) basal short-axis view, (E) 3-chamber view, and (F) 4-chamber view show diffuse myocardial late gadolinium enhancement with subepicardial distribution (arrows) and sparing of the basal and mid-septal segments; thickening and enhancement of pericardium can also be seen (arrowheads).