Myocarditis Following Immunization With mRNA COVID-19 Vaccines in Members of the US Military

U.S, 29 June 2021, Montgomery et al, JAMA Cardiology

Summary

In this case series of 23 male patients, including 22 previously healthy military members, myocarditis was identified within 4 days of receipt of a COVID-19 vaccine. Each patient had a final diagnosis of myocarditis without infectious, ischemic, or autoimmune etiologies identified. All patients presented with acute chest pain and significantly elevated cardiac troponin levels (10-fold to 400-fold the upper limits of their respective reference ranges). Their symptoms began within 12 to 96 hours following immunization with an mRNA COVID-19 vaccine. Sixteen had received the mRNA-1273 vaccine (Moderna), and 7 had received the BNT162b2-mRNA vaccine (Pfizer-BioNTech). For all but 3 patients, the second dose of vaccine preceded their myocarditis presentations. Echocardiography in 4 patients (17%) demonstrated reduced left ventricular ejection fractions (40% to 50%).

Demographic and Clinical Characteristics of 23 Military Health System Patients With Myocarditis Following COVID-19 Vaccination, January-April 2021

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