Myocarditis After BNT162b2 and mRNA-1273 Vaccination

Italy, 10 August 2021, Larson et al, Circulation


Case series of 8 patients who were hospitalized with chest pain and who were diagnosed with myocarditis by laboratory and cardiac magnetic resonance imaging within 2 to 4 days of receiving either the BNT162b2 or mRNA1273 vaccine. All individuals were otherwise healthy males between the ages
of 21 and 56 years. All but 1 patient developed symptoms after their second dose. Left ventricular ejection fraction was reduced (<50%) in 2 of 8 (25%) patients with a median left ventricular ejection fraction of 51.5% (first to third quartile, 48% to 59%).

Five patients demonstrated regional wall motion abnormalities with inferior and inferolateral walls involved, and the remaining 3 cases had generalized hypokinesis. All but 3 patients underwent coronary imaging by computed tomography or catheter-based angiography
to rule out coronary artery disease. Cardiac magnetic resonance imaging revealed patchy delayed gadolinium enhancement consistent with myocarditis in all patients, and most patients also demonstrated findings consistent with myocardial edema.

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