Medical Case Reports

mRNA vaccination can, in relatively rare cases, trigger a spectrum of immune-mediated cardiac effects ranging from transient myocardial inflammation and biomarker elevation to clinically apparent myocarditis, with fulminant myocarditis representing the most severe but least common manifestation A new Stanford Medicine study sheds light on a long-standing question: why do mRNA-based COVID-19 vaccines could cause myocarditis, particularly in young males? Importantly, the findings also point toward possible ways to reduce this risk without undermining vaccine effectiveness. The researchers identified a two-step immune reaction behind vaccine-associated myocarditis. After vaccination, macrophages (frontline immune cells) release a signaling protein called CXCL10. This, in turn, activates T cells, which produce another inflammatory molecule, interferon-gamma (IFN-γ). Together, these cytokines act as a “tag team,” driving inflammation that can directly injure heart muscle cells and attract a...

A 35-year-old woman with history of cardiovascular disease presented with shortness of breath, lightheadedness, fatigue, chest pain, and premature ventricular contractions (pericarditis) 3 weeks after her second COVID-19 vaccine.  Some long-COVID–like symptoms  subsided following treatment except for chest pain and fatigue .  3 weeks later, the patient tested positive for SARS-CoV-2 .  Shortly after infection, the patient presented again with chest pain when moving or breathing, joint pain, and dermatitis, symptoms that persisted for 6 months.   Antinuclear antibody (ANA) Immunofluorescence assay screening was positive for autoimmune antibodies. This is in line with our findings about higher probability of breakthrough infections among those with long-COVID-like reactions to COVID-19 vaccines and genetic origins of some adverse reactions.  The patient has a family history of diabetes, high blood pressure, and cardiac cirrhosis. Genetic anal...

49-year-old woman was diagnosed with myocarditis and pulmonary embolism due to a COVID-19 complication, which led to heart failure with reduced ejection fraction. A month later she received the first dose of  the Pfizer–BioNTech COVID-19 vaccine with no notable side effects. 12 days after her second dose, however, she  presented to a hospital with chest pain, nausea and vomiting. The vital signs included a heart rate of 90 beats per minute and blood pressure of 100/80 mmHg. Pulmonary sounds were absent on the right lung base and there were signs of poor perfusions, such as capillary refill time (CRT) longer than 5 seconds. The initial electrocardiogram showed sinus rhythm, left bundle branch block and left axis deviation.  A computed tomography (CT) angiography ​(showed pleural effusion, larger in the right hemithorax.  Based on the patient’s medical record, this clinical presentation was interpreted as acute decompensated heart failur...

I n line with results from a cohort study in Nordic countries , analyses of data from France show a significant risk and population burden of pericarditis following the second dose of the BNT162b2 and mRNA-1273 vaccine (Note that cases after third dose have been also reported) The study was based on data of the National Health Data System (SNDS) which covers more than 99% of the French population (67 million inhabitants) .  1612 cases of myocarditis and 1613 cases of pericarditis occurred in France in the period from May 12, 2021 to October 31, 2021. The largest associations are observed for myocarditis following mRNA-1273 vaccination in persons aged 18 to 24 years. Estimates of excess cases attributable to vaccination also reveal a substantial burden of both myocarditis and pericarditis across other age groups and in both males and females. REFERENCES Le Vu, Stéphane;  Bertrand, Marion;  Jabagi, Marie-Joelle;  Botton, Jérémie ; Drouin, Jérôme;  Baricault, Béra...