Nonsustained ventricular tachycardia in adolescents after mRNA-SARS-CoV-2 vaccine: Report of two cases
Thoracic and Cardiovascular Surgeon
; 70(SUPPL 2), 2022.
Article
in English
| EMBASE | ID: covidwho-1747135
ABSTRACT
Background:
In young adults and adolescent males, myocarditis has been described as a rare complication of SARS-CoV-2 mRNA-vaccination. Reported findings include chest pain, elevated troponin levels, and cardiac MRI abnormalities. ECG abnormalities include ST-elevation but to our knowledge, ventricular arrhythmia has not been yet described. In the vast majority of reported cases, symptoms were relatively mild and patients recovered fully.Method:
Here, we report two male adolescents (15 resp. 13 years old) admitted to our hospital with nonsustained (ns) VT and chest pain (patient no. 1) and near syncope (patient no. 2) after receiving an mRNA-SARS-CoV-2 vaccine (patient no. 1 4 days after the second dose and patient no. 2 15 days after days after the first dose). Further workup included family history, standard 12 lead ECG, the Holter monitoring, heart catheterization, myocardial biopsy, invasive programmed RV stimulation, and cardiac MRI.Results:
Both patients did not have elevated troponin levels nor specific ECG findings. Family history was free for cardiac diseases, sudden cardiac death, or syncopal episodes. The Holter monitoring showed recurrent ns VT in one patient. Cardiac MRI and myocardial biopsy in both patients did not show evidence of myocarditis, but both patients showed severe thickening of the arterioles in myocardial biopsy. Invasive RV-stimulation did not trigger VT. Ultimately, both patients did not meet diagnostic criteria for myocarditis and β-blockers were started for ns VT. As of today, four more patients in age group 12 to 17 years were diagnosed with vaccine-associated myocarditis in our institution and one male with COVID-19 associated myocarditis. Notably, none of these patients had ventricular tachycardia or other cardiac arrhythmia.Conclusion:
We observed ventricular tachycardia after SARS-CoV-2-mRNA vaccination in two adolescent males. This manifestation seems to be distinct from the well-described vaccine-associated myocarditis. Interestingly in both patients, perivascular thickening of arterioles was noted in biopsy. The mechanism and causality of ventricular arrhythmia in association with SARS-CoV-2 mRNA vaccines remain unclear and requires further observation.
beta adrenergic receptor blocking agent; endogenous compound; messenger RNA; SARS-CoV-2 vaccine; troponin; adolescent; adult; adverse drug reaction; arteriole; cardiovascular magnetic resonance; case report; child; clinical article; complication; conference abstract; coronavirus disease 2019; diagnosis; drug therapy; ECG abnormality; electrocardiogram; electrocardiography; family history; gene expression; groups by age; heart arrhythmia; heart catheterization; heart muscle biopsy; heart ventricle arrhythmia; heart ventricle tachycardia; Holter monitoring; human; male; myocarditis; nonhuman; presyncope; Severe acute respiratory syndrome coronavirus 2; side effect; ST segment elevation; sudden cardiac death; thorax pain; vaccination; young adult
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Topics:
Vaccines
Language:
English
Journal:
Thoracic and Cardiovascular Surgeon
Year:
2022
Document Type:
Article
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