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Fulminant myocarditis following coronavirus disease 2019 vaccination: a case report

Arianne Clare C Agdamag1, Daniel Gonzalez1, Katie Carlson2

  • 1Division of Cardiology, Department of Medicine, University of Minnesota, 420 Delaware St., Minneapolis, MN 55455, USA.

European Heart Journal. Case Reports
|January 28, 2022
PubMed

Insights

Severe myocarditis is a rare complication following the BNT162b2 COVID-19 vaccine. This case highlights the importance of recognizing this adverse event, though vaccine benefits outweigh risks.

Area of Science:

  • Cardiology
  • Immunology
  • Vaccinology

Background:

  • The BNT162b2 vaccine (Pfizer-BioNTech) received emergency use authorization for preventing severe COVID-19.
  • Myocarditis is a potential, albeit rare, adverse event associated with vaccination.

Observation:

  • An 80-year-old female developed biopsy-proven fulminant myocarditis and cardiogenic shock within 12 days of her first BNT162b2 vaccine dose.
  • The patient required mechanical circulatory support, inotropic agents, and high-dose steroids for management.
  • Cardiac function recovered, with repeat MRI showing improved biventricular function and reduced myocardial inflammation after 3 months.

Findings:

  • Fulminant myocarditis can occur as a rare complication post-BNT162b2 vaccination.
  • Prompt medical intervention and management are crucial for patient recovery.
  • Complete cardiac recovery is possible in severe cases of vaccine-associated myocarditis.

Implications:

  • Clinicians must maintain vigilance for rare vaccine-related complications like myocarditis.
  • Early recognition and management are key to improving outcomes.
  • The established benefits of COVID-19 vaccination significantly outweigh the rare risks of adverse events.
Abstract

Keywords:
COVID-19Cardiogenic shockCase reportMechanical circulatory support deviceMyocarditisVaccine

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