Myocardial infarction or myocarditis? A case report and review of a myocardial adverse event associated with mRNA vaccine

• Published in: Frontiers in medicine Vol. 10; p. 1071239
• Main Authors: Badaró, Roberto, Novaes, Gustavo, Andrade, Ana Cristina, de Araujo Neto, Cesar Augusto, Machado, Bruna Aparecida, Barbosa, Josiane Dantas Viana, Soares, Milena Botelho Pereira
• Format: Journal Article
• Language: English
• Published: Switzerland Frontiers Media S.A 02-02-2023
• Subjects: adverse event; cardiac disease; cardiotoxicity; COVID-19; Medicine; mRNA vaccine; COVID-19; adverse event; cardiac disease; cardiotoxicity; mRNA vaccine
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2023.1071239

A 23-year-old man started with chest pain 8 h after his first Pfizer-BioNTech COVID-19 vaccination. ECG evaluation showed sinus tachycardia with ST-segment elevation in D1, AVL, V5, and V6, the findings compatible with acute subepicardial myocardial damage. However, cardiac MRI documented myocardial fibrosis, with cardiac late enhancement non-ischemic pattern with diffuse edema. He had no other symptoms to suggest another etiology than the vaccination. The patient was hospitalized and received corticosteroid (prednisolone) daily. Then, 2 weeks after hospitalization, all laboratory parameters and ECG were normal and the patient was discharged from the hospital. The patient had a history of Wolf-Parkinson White that was corrected with ablation when he was 11 years old. This report calls attention to myocardial adverse reaction risk for mRNA COVID-19 vaccines for people with a previous cardiac disease history.