Myocarditis and Pericarditis After COVID-19 mRNA Vaccination: Practical Considerations for Care Providers.
Can J Cardiol
; 37(10): 1629-1634, 2021 10.
Article
in English
| MEDLINE | ID: covidwho-1406216
ABSTRACT
The mRNA vaccines against COVID-19 infection have been effective in reducing the number of symptomatic cases worldwide. With widespread uptake, case series of vaccine-related myocarditis/pericarditis have been reported, particularly in adolescents and young adults. Men tend to be affected with greater frequency, and symptom onset is usually within 1 week after vaccination. Clinical course appears to be mild in most cases. On the basis of the available evidence, we highlight a clinical framework to guide providers on how to assess, investigate, diagnose, and report suspected and confirmed cases. In any patient with highly suggestive symptoms temporally related to COVID-19 mRNA vaccination, standardized workup includes serum troponin measurement and polymerase chain reaction testing for COVID-19 infection, routine additional lab work, and a 12-lead electrocardiogram. Echocardiography is recommended as the imaging modality of choice for patients with unexplained troponin elevation and/or pathologic electrocardiogram changes. Cardiovascular specialist consultation and hospitalization should be considered on the basis of the results of standard investigations. Treatment is largely supportive, and myocarditis/pericarditis that is diagnosed according to defined clinical criteria should be reported to public health authorities in every jurisdiction. Finally, we recommend COVID-19 vaccination in all individuals in accordance with the Health Canada and National Advisory Committee on Immunization guidelines. In patients with suspected myocarditis/pericarditis after the first dose of an mRNA vaccine, deferral of a second dose is recommended until additional reports become available.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Pericarditis
/
Risk Management
/
COVID-19 Vaccines
/
COVID-19
/
MRNA Vaccines
/
Myocarditis
Type of study:
Diagnostic study
/
Observational study
/
Prognostic study
Topics:
Vaccines
Limits:
Adult
/
Female
/
Humans
/
Male
/
Young adult
Country/Region as subject:
North America
Language:
English
Journal:
Can J Cardiol
Journal subject:
Cardiology
Year:
2021
Document Type:
Article
Affiliation country:
J.cjca.2021.08.001
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