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Case Reports
. 2021 Nov;42(11):797-800.
doi: 10.1016/j.revmed.2021.10.003. Epub 2021 Oct 19.

Acute Myocarditis after COVID-19 vaccination: A case report

P Schmitt  1 , R Demoulin  2 , R Poyet  3 , E Capilla  3 , G Rohel  3 , F Pons  3 , C Jégo  3 , S Sidibe  3 , A Druelle  4 , F-X Brocq  5 , F Dutasta  6 , G R Cellarier  3
Affiliations
Case Reports

Acute Myocarditis after COVID-19 vaccination: A case report

P Schmitt et al. Rev Med Interne. 2021 Nov.

Abstract
in English, French

Introduction: The etiology of myocarditis often remains undetermined. A large variety of infectious agents, systemic diseases, drugs, and toxins can cause the disease. We report the case of a 19-year-old man who developed myocarditis three days after Pfizer-BioNTech COVID-19 booster vaccination.

Case report: A 19-year-old man, presenting with troponin-positive acute chest pain, was referred to our department. He had received the Pfizer-BioNTech COVID-19 vaccine three days prior to his admission. The diagnosis of acute myocarditis was confirmed by cardiovascular magnetic resonance imaging. Patient hemodynamic status remained stable during hospitalization. The left ventricular ejection fraction was preserved during hospital stay and at one-month follow-up. We found no evidence for another infectious or autoimmune etiology.

Conclusion: Although imputability of the vaccine cannot be formally established on the basis of this case report, the findings raise the possibility of an association between mRNA COVID-19 vaccination and acute myocarditis.

Introduction: L’étiologie des myocardites reste souvent indéterminée. Une grande variété d’agents infectieux, de maladies systémiques, de médicaments et de toxines peuvent causer la maladie. Nous rapportons le cas d’un homme de 19 ans ayant développé une myocardite trois jours après une vaccination de rappel Pfizer-BioNTech COVID-19.

Observation: Un homme de 19 ans, présentant une douleur thoracique aiguë avec élévation significative de la troponine, a été adressé à notre service. Il avait reçu le vaccin Pfizer-BioNTech COVID-19 trois jours avant son admission. Le diagnostic de myocardite aiguë a été confirmé par une imagerie par résonance magnétique cardiaque. L’état hémodynamique du patient est resté stable pendant l’hospitalisation. La fraction d’éjection du ventricule gauche a été préservée pendant l’hospitalisation et lors du suivi à un mois. Nous n’avons trouvé aucune preuve d’une autre étiologie infectieuse ou auto-immune.

Conclusion: Bien que l’imputabilité du vaccin ne puisse être formellement établie sur la base d’un cas clinique, ces résultats soulèvent une possible association entre la vaccination par le mRNA COVID-19 et la myocardite aiguë.

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Figures

Fig. 1
Fig. 1
Electrocardiogram in sinus rhythm showing a PR depression in inferior leads (orange arrows) and a persistent concave ST elevation (blue arrows) without reciprocal depression.
Fig. 2
Fig. 2
Cardiac magnetic resonance imaging short axis (A) and four chamber (B) views with late gadolinium enhancement sequences identifying a lateral subepicardial enhancement.
See this image and copyright information in PMC

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