Fatal myocarditis after vaccination

Thousands of case reports of myocarditis after COVID-19 vaccination have been published in medical literature. Some of them were fatal. 

A 27-year-old athletic man was transferred to the emergency room due to cardiopulmonary arrest 8 days after the first dose of the mRNA-1273 SARS-CoV-2 vaccine (Moderna, Cambridge, MA, USA). His teammates called for an ambulance when he was found sitting unconscious during practice. A chest radiograph obtained in an emergency room showed an enlarged heart and pulmonary congestion (Panel E). The patient had undergone orthopedic surgery 3 months before the recent hospitalization. An electrocardiogram (ECG) 
abnormality and mild cardiac shadow enlargement in chest radiograph had been also noted preoperatively (
Panels B, D); however, since he was asymptomatic, no further examination was performed. Endomyocardial biopsy performed before death showed no evidence of myocarditis; therefore, cardiopulmonary arrest due to arrhythmic mitral valve prolapse was considered a possible differential diagnosis. However, the autopsy showed obvious severe myocardial inflammation findings, leading to the diagnosis of myocarditis. 

Hoshino N, Yanase M, Ichiyasu T, Kuwahara K, Kawai H, Muramatsu T, Ishii H, Tsukamoto T, Morimoto SI, Izawa H. An autopsy case report of fulminant myocarditis: Following mRNA COVID-19 vaccination. Journal of Cardiology Cases. 2022 Jul 4.


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