Delayed myocarditis following vaccination
![Image](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhG2-M1-BJryBcr4RsjH1xQORD8ys41n86mKVnGOnKSIG-TpfrTsewmAJ1kZHqKa9neL020lpUt0VYIKv8-JXtZtj4Hurdblwd7tkknRFRMd0jihIW7G0R1l8uQPGYK6xocsJ-yQ5Y4Ez8xf7BaTXyE_hW0fC_b9Qx_dUP3ZORz-VfbQYAa6L8AauH53kQ/s320/delayedmyoc.png)
A healthy 24-year-old man with a history of allergic rhinitis experienced tightness in his chest, difficulty breathing, and coughing up blood six months after exposure to COVID-19 (he never tested positive nor experienced any symptoms) and three months after a second dose of the Moderna vaccine. On arrival, his oxygen level was low, his heart rate was high, he had a fever, and his blood pressure was normal. He looked very sick and was sweating. Electrocardiography (ECG) showed sinus tachycardia with diffuse ST-segment elevation and T-wave inversion (Figure). There were abnormal sounds in his lungs despite normal X-rays. His heart's electrical activity showed a fast rhythm with changes in the ST-segment and T-wave. Blood tests indicated heart damage and inflammation. An ultrasound of his heart showed that its pumping ability was reduced. A biopsy of his heart muscle confirmed inflammation Tests of fluid from his lungs showed no signs of bleeding or infection. Diagnosis was a del