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A Possibility of Vasospastic Angina after mRNA COVID-19 Vaccination
Toru Awaya1, Masao Moroi1, Fuminori Nakamura1
1Department of Cardiovascular Medicine, Toho University Ohashi Medical Center, 2-22-36 Ohashi Meguro-ku, Tokyo 153-8515, Japan.
Abstract:
We report a case of vasospastic angina (VSA) following COVID-19 mRNA vaccination. Despite the widespread occurrence of myocarditis, there have been few reports of post-vaccinal VSA. A 41-year-old male patient was referred for chest pain at rest following mRNA vaccination; he had never experienced chest pain prior to vaccination. He was diagnosed by an acetylcholine (Ach) provocation test that showed multivessel vasospasm. After the initiation of treatment with a calcium channel blocker and nitrate, no further exacerbation of chest pain was observed. To our knowledge, this constitutes the first reported case of VSA proven by Ach provocation test after COVID-19 vaccination. The vaccination may increase coronary artery spasticity. VSA should be ruled out in post-vaccine new onset resting chest pain.
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