Acute myocarditis after receiving first dose of BNT162b2 mRNA vaccine

A 40-year-old man with history of prior coronavirus disease 2019 (COVID-19) infection developed pleuritic chest pain 3 days after receiving the first dose of the BNT162b2 mRNA vaccine. Echocardiography results were significant for mild dysfunction and left ventricular hypertrophy. Cardiac magnetic resonance imaging showed myocardial edema as well as delayed enhancement in the inferior wall of the basal left ventricular myocardium, suggestive of acute myocarditis. This case describes the work-up, diagnosis, risk-stratification, and management of acute myocarditis post BNT162b2 mRNA vaccine. <Learning objective:1.To suspect acute myocardial inflammation in patients who present with chest symptoms after receiving the BNT162b2 COVID-19 vaccine.2.To review the clinical presentation and laboratory, electrocardiographic, and imaging parameters for diagnosing acute myocarditis.3.To review the indications for endomyocardial biopsy in patients presenting with possible myocarditis.>.