key: cord-0811703-ggp1bcul
authors: Bengel, Christopher Paul; Kacapor, Rifat
title: A report of two cases of myocarditis following mRNA COVID-19 vaccination
date: 2022-01-09
journal: Eur Heart J Case Rep
DOI: 10.1093/ehjcr/ytac004
sha: f004390188f6f905b1098c7123b3d3810afb474c
doc_id: 811703
cord_uid: ggp1bcul

BACKGROUND: Vaccination is the most important measure to control the coronavirus disease 2019 (COVID-19) pandemic. Myocarditis has been reported as a rare adverse reaction to COVID-19 vaccines. The clinical presentation of myocarditis in such cases can range from mild general symptoms to acute heart failure. CASE SUMMARY: We report the cases of two young men who presented with chest pain and dyspnoea following the administration of the mRNA COVID-19 vaccine. Cardiac investigations revealed findings typical of acute myocarditis. DISCUSSION: Myocarditis is a rare complication following mRNA COVID-19 vaccination. In this case series, the temporal proximity of the development of acute myocarditis and the administration of the mRNA COVID-19 vaccine was acknowledged. In the absence of other causative factors, myocarditis in these patients potentially occurred due to an adverse reaction to the mRNA COVID-19 vaccine. However, a causal relationship remains speculative. Clinical suspicion of myocarditis should be high if patients present with chest pain or dyspnoea after receiving COVID-19 vaccination.

We report the cases of two young men who presented with chest pain and dyspnoea following the 10 administration of the mRNA COVID-19 vaccine. Cardiac investigations revealed findings typical of acute 11 myocarditis.

Vaccination is an essential means to control the coronavirus disease 2019 (COVID-19) pandemic.

Myocarditis has been reported as a rare adverse reaction to COVID-19 vaccines. 

There was no family history of genetic or autoimmune diseases. A bacterial infectious cause of 70 myocarditis was improbable as there were no predisposing comorbidities and rapid recovery was 71 achieved without antibiotic therapy.

A quantitative SARS-CoV-2 antibody assay (SARS-CoV-2 TrimericS IgG Assay, DiaSorin, Saluggia,

Italy) was performed and revealed an antispike postvaccination titre of >2080 BAU/mL (normal: <33.8 74 BAU/mL). COVID-19 PCR testing was negative.

The patient was monitored for 4 days with no relevant heart rhythm anomalies. Repeat properties (9). In this patient, we did not consider the ST-elevations as a sign of acute ischaemia.

Therefore, coronary angiography was performed the next morning and not immediately. Although friction rubs. Hence, a diagnosis of myopericarditis seemed less probable. Nevertheless, we continued 154 colchicine therapy.

In case 1, there was a discrepancy in the findings between cardiac MRI and echocardiography. Regional 156 wall motion abnormalities on cardiac MRI were probably evident because of better endocardial 157 definition, whereas no wall motion abnormalities were seen on echocardiography.

The quantitative SARS-CoV-2 antibody assay revealed high titres in both patients. Thus, the vaccination 159 of the patients could be considered effective (10).

Recently published cases of myocarditis after COVID-19 vaccination reported similar clinical courses.

There was a predominance of male patients. Almost all had received mRNA vaccines. Symptom onset 162 began shortly after the administration of the second dose, and the resolution of symptoms was rapid (1-163 5). Previous reports described normal LV function in a majority of patients (1) (2) (3) (4) (5) 

Myocarditis is a rare complication following administration of the mRNA COVID-19 vaccine (1) (2) (3) (4) (5) . It is 170 also a rare complication of vaccination in general (11). In this case series, the temporal proximity of the 

Myocarditis temporally

Standing Committee on Vaccination. STIKO communication on the update of 272 the COVID-19 vaccination recommendation for children and adolescents

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