COVID-19 Vaccine-Induced Acute Perimyocarditis: A Case Report.

Perimyocarditis is the inflammation of the pericardium along with the myocardium. Presentation is similar to acute pericarditis, but it is associated with myocardial damage, leading to an elevation in serum troponin and a left ventricular dysfunction (manifested as an ejection fraction of less than 55 percent). Perimyocarditis is mostly managed like acute myocarditis. Etiology is generally idiopathic and likely secondary to viral infections. Cases of vaccine-associated myocarditis have been infrequently reported in past, most recently with the COVID-19 mRNA vaccine. We present a rare case of a young healthy adolescent male who developed perimyocarditis after the first booster dose of the COVID-19 mRNA vaccine.

Cardiovascular magnetic resonance findings in young adult patients with acute myocarditis following mRNA COVID-19 vaccination: a case series.

BACKGROUND: Messenger RNA (mRNA) coronavirus disease of 2019 (COVID-19) vaccine are known to cause minor side effects at the injection site and mild global systemic symptoms in first 24-48 h. Recently published case series have reported a possible association between acute myocarditis and COVID-19 vaccination, predominantly in young males. METHODS: We report a case series of 5 young male patients with cardiovascular magnetic resonance (CMR)-confirmed acute myocarditis within 72 h after receiving a dose of an mRNA-based COVID-19 vaccine. RESULTS: Our case series suggests that myocarditis in this setting is characterized by myocardial edema and late gadolinium enhancement in the lateral wall of the left ventricular (LV) myocardium, reduced global LV longitudinal strain, and preserved LV ejection fraction. All patients in our series remained clinically stable during a relatively short inpatient hospital stay. CONCLUSIONS: In conjunction with other recently published case series and national vaccine safety surveillance data, this case series suggests a possible association between acute myocarditis and COVID-19 vaccination in young males and highlights a potential pattern in accompanying CMR abnormalities.

A Case of Isolated SARS-CoV-2 Fulminant Myopericarditis Without Respiratory Failure.

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several cardiovascular complications of COVID-19 have been described in clinical studies. While those with pre-existing cardiovascular disease seem to have worse outcomes, growing evidence suggests that COVID-19 itself can cause myocardial injury, arrhythmia, and heart failure. We report a case of a 27-year-old male with no known comorbidities who presented with nausea, vomiting and non-radiating substernal chest pressure without respiratory symptoms in May of 2020. Laboratory findings showed elevated cardiac biomarkers and electrocardiogram showed diffuse ST-segment elevation. Coronary angiography revealed normal coronaries but findings suggestive of cardiogenic shock. Reverse transcription polymerase chain reaction for SARS-CoV-2 returned positive. He was treated for fulminant myopericarditis and cardiogenic shock with remdesivir, steroid, inotropes and vasopressors but rapidly deteriorated and went into cardiac arrest and was unable to be resuscitated despite multiple rounds of cardiopulmonary resuscitation. Fulminant myopericarditis is a rare complication of COVID-19 with high mortality that requires early recognition, treatment and a transfer to a tertiary facility with advanced cardiac services.

Acute Myopericarditis in the Post COVID-19 Recovery Phase.

The COVID-19 viral infection, caused by the novel coronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is a currently ongoing global pandemic that, as of mid-October, 2020, has resulted in more than 38.7 million confirmed cases globally and has caused more than 1.1 million fatalities. COVID-19 infection is associated with severe life threatening respiratory and cardiac complications such as acute respiratory distress syndrome (ARDS), pneumonia, shock, cardiac arrhythmias, myocardial infarction and heart failure, particularly in the acute infectious stage. Acute myopericarditis is another reported cardiac complication of COVID-19. Case reports have been limited in reporting the effects of COVID-19 in the post-symptomatic period. In this article, we present a case of acute myopericarditis resulting 6 to 8 weeks after testing positive for COVID-19. Here we will breakdown the initial emergency department (ED) presentation, with particular attention to the electrocardiogram (ECG) findings of acute myopericarditis. This case, to the our best knowledge and after an extensive literature review, depicts the first case of myopericarditis in the post COVID-19 infection recovery phase.