Cardiac complications following mRNA COVID-19 vaccines: A systematic review of case reports and case series

Editorial Material Immunology

Insights From a Murine Model of Coronavirus Disease 2019 (COVID-19) mRNA Vaccination-Induced Myopericarditis: Could Accidental Intravenous Vaccine Injection Induce Myopericarditis?

Kirk U. Knowlton

CLINICAL INFECTIOUS DISEASES (2022)

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Letter Medicine, General & Internal

Myocarditis should be considered in those with a troponin rise and unobstructed coronary arteries following Pfizer-BioNTech COVID-19 vaccination

A. Ioannou

QJM-AN INTERNATIONAL JOURNAL OF MEDICINE (2022)

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Editorial Material Cardiac & Cardiovascular Systems

Acute myocarditis after SARS-CoV-2 vaccination in a 24-year-old man

Paolo Cimaglia et al.

REVISTA PORTUGUESA DE CARDIOLOGIA (2022)

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Article Cardiac & Cardiovascular Systems

Acute myocarditis after COVID-19 vaccination with mRNA-1273 in a patient with former SARS-CoV-2 infection

Tien Dung Nguyen et al.

Summary: A 20-year-old man developed acute myocarditis 12 hours after receiving the mRNA-1273 vaccine, with endomyocardial biopsy showing significant infiltration of monocytes and T lymphocytes. Despite detection of IgG against SARS-CoV-2 nucleocapsid protein in his body, viral genome analysis was negative, implying a potential association with the vaccine.

ESC HEART FAILURE (2022)

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Article Medicine, General & Internal

Cardiovascular Adverse Events Reported from COVID-19 Vaccines: A Study Based on WHO Database

Rimple Kaur et al.

International Journal of General Medicine (2021)

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Review Endocrinology & Metabolism

COVID-19 vaccine-induced myocarditis: Case report with literature review

Mahmoud Nassar et al.

DIABETES & METABOLIC SYNDROME-CLINICAL RESEARCH & REVIEWS (2021)

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Article

Takotsubo syndrome after receiving the COVID-19 vaccine

Colleen Fearon et al.

Journal of Cardiology Cases (2021)

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Article Cardiac & Cardiovascular Systems

Pericarditis after administration of the BNT162b2 mRNA COVID-19 vaccine

Almudena Ramírez-García et al.

Revista española de cardiología (English ed.) (2021)

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Article Cardiac & Cardiovascular Systems

Acute myocarditis after administration of the BNT162b2 vaccine against COVID-19

Javier Bautista García et al.

Revista española de cardiología (English ed.) (2021)

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Letter Cardiac & Cardiovascular Systems

COVID-19 Vaccine and Myocarditis

Husam M. Salah et al.

AMERICAN JOURNAL OF CARDIOLOGY (2021)

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Article Immunology

Autoimmune phenomena following SARS-CoV-2 vaccination

Yuval Ishay et al.

Summary: Vaccines are seen as a potential solution to the COVID-19 pandemic, but widespread distribution has been hindered by concerns over side effects. In Israel, where a large percentage of the population has been vaccinated, cases of autoimmune conditions following vaccination have been observed, but they generally have mild symptoms requiring modest treatment.

INTERNATIONAL IMMUNOPHARMACOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Fulminant myocarditis and systemic hyperinflammation temporally associated with BNT162b2 mRNA COVID-19 vaccination in two patients

Antonio Abbate et al.

Summary: Immune-mediated myocardial injury can occur in both adults and children following infection with SARS-CoV2. Recent cases have shown myocarditis following immunization for SARS-CoV2, with most cases being mild and showing spontaneous recovery.

INTERNATIONAL JOURNAL OF CARDIOLOGY (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Acute myocarditis associated with the Pfizer/BioNTech vaccine

Monika Shumkova et al.

KARDIOLOGIA POLSKA (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Every rose has its thorns - acute myocarditis following COVID-19 vaccination

Justyna M. Sokolska et al.

KARDIOLOGIA POLSKA (2021)

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Review Oncology

Current treatment strategies for COVID-19

Fabin Han et al.

Summary: The rapid spread of COVID-19 has led to a search for effective treatments, with controversial findings on certain therapies. Research is ongoing to investigate the molecular mechanisms of various therapeutic agents against SARS-CoV2.

MOLECULAR MEDICINE REPORTS (2021)

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Article Medicine, General & Internal

Myocarditis after Covid-19 Vaccination in a Large Health Care Organization

Guy Witberg et al.

Summary: Among 2.5 million patients who received the BNT162b2 mRNA vaccine in a large Israeli health care system, the incidence of myocarditis at 42 days was 2.13 cases per 100,000 persons, with the highest incidence (10.69 per 100,000 persons) among male patients between the ages of 16 and 29 years. Most cases of myocarditis were mild or moderate.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Medicine, General & Internal

Myocarditis after BNT162b2 mRNA Vaccine against Covid-19 in Israel

D. Mevorach et al.

Summary: The incidence of myocarditis increased after receiving the BNT162b2 vaccine in Israel, particularly after the second dose among young male recipients. The clinical presentation of myocarditis after vaccination was usually mild.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Acute Coronary Tree Thrombosis After Vaccination for COVID-19

Mateusz Tajstra et al.

JACC-CARDIOVASCULAR INTERVENTIONS (2021)

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Article Chemistry, Multidisciplinary

The dawn of mRNA vaccines: The COVID-19 case

Rein Verbeke et al.

Summary: In less than a year since the COVID-19 pandemic outbreak, mRNA vaccines have made significant progress, with two receiving emergency use authorization and one moving to phase 3 clinical testing. These mRNA vaccines represent a new class of vaccine products, encoding the SARS-CoV-2 Spike glycoprotein to deliver mRNA to cells. The review provides a detailed overview of the composition, clinical performance, and design considerations of the most advanced mRNA vaccines, highlighting new insights and areas for future research and optimization.

JOURNAL OF CONTROLLED RELEASE (2021)

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Review Medicine, General & Internal

The PRISMA 2020 statement: an updated guideline for reporting systematic reviews

Matthew J. Page et al.

Summary: The PRISMA statement was designed to help systematic reviewers transparently report the purpose, methods, and findings of their reviews. The updated PRISMA 2020 statement includes new reporting guidance, a 27-item checklist, an abstract checklist, and revised flow diagrams for reviews.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Article Emergency Medicine

Myocarditis after BNT162b2 vaccination in a healthy male

Kevin Watkins et al.

AMERICAN JOURNAL OF EMERGENCY MEDICINE (2021)

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Letter Cardiac & Cardiovascular Systems

COVID-19 vaccines and myocarditisVaccins

Mathieu Kerneis et al.

ARCHIVES OF CARDIOVASCULAR DISEASES (2021)

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Article

Acute myocarditis following Comirnaty vaccination in a healthy man with previous SARS-CoV-2 infection

Anna Patrignani et al.

Radiology Case Reports (2021)

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Article Cardiac & Cardiovascular Systems

Myocarditis and Pericarditis After COVID-19 mRNA Vaccination: Practical Considerations for Care Providers

Adriana Luk et al.

Summary: The mRNA vaccines against COVID-19 have been effective in reducing symptomatic cases globally, but cases of vaccine-related myocarditis/pericarditis have been reported, especially in male adolescents and young adults with symptom onset typically within 1 week after vaccination. A clinical framework is highlighted to guide providers on assessing, investigating, diagnosing, and reporting suspected and confirmed cases, with recommended standardized workup and imaging modalities such as echocardiography for unexplained elevations in troponin. Treatment is supportive, and diagnosis based on defined clinical criteria should be reported to public health authorities. Recommendations include vaccination in accordance with Health Canada and National Advisory Committee on Immunization guidelines, with deferral of a second dose for patients with suspected myocarditis/pericarditis after the first dose of an mRNA vaccine.

CANADIAN JOURNAL OF CARDIOLOGY (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Myocarditis After SARS-CoV-2 Vaccination: A Vaccine-Induced Reaction?

Tommaso D'Angelo et al.

Summary: Vaccination is crucial in combating COVID-19, but can rarely lead to myocarditis. We present a case of a male patient who developed myopericarditis after receiving the vaccine.

CANADIAN JOURNAL OF CARDIOLOGY (2021)

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Article Immunology

Neurologic adverse events among 704,003 first-dose recipients of the BNT162b2 mRNA COVID-19 vaccine in Mexico: A nationwide descriptive study

Miguel Garcia-Grimshaw et al.

Summary: mRNA vaccines against SARS-CoV-2 are shown to be safe and effective, with low incidence of adverse events post-immunization, most of which are non-serious, with neurologic AEFIs being the majority. The vaccines offer significant individual and societal benefits, outweighing the low percentage of serious neurologic AEFIs, which should help dispel hesitancy towards this new vaccine platform.

CLINICAL IMMUNOLOGY (2021)

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Editorial Material Medicine, General & Internal

Exploring the possible link between myocarditis and mRNA COVID-19 vaccines

Gianfranco Sinagra et al.

EUROPEAN JOURNAL OF INTERNAL MEDICINE (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Takotsubo Cardiomyopathy After mRNA COVID-19 Vaccination

Martina Boscolo Berto et al.

HEART LUNG AND CIRCULATION (2021)

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Letter Peripheral Vascular Disease

Stage III Hypertension in Patients After mRNA-Based SARS-CoV-2 Vaccination

Sylvain Meylan et al.

HYPERTENSION (2021)

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Review Biochemistry & Molecular Biology

Treatment and prevention strategies for the COVID 19 pandemic: A review of immunotherapeutic approaches for neutralizing SARS-CoV-2

Pravas Kumar Baral et al.

Summary: Researchers worldwide are working on developing prophylactic and therapeutic interventions to combat the COVID-19 crisis, with a focus on antibody-based therapies targeting the viral spike protein, particularly monoclonal antibodies.

INTERNATIONAL JOURNAL OF BIOLOGICAL MACROMOLECULES (2021)

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Article Medicine, General & Internal

Surveillance for Adverse Events After COVID-19 mRNA Vaccination

Nicola P. Klein et al.

Summary: This study conducted interim analysis of safety surveillance data of mRNA COVID-19 vaccines and found that the incidence of selected serious outcomes within 1-21 days post-vaccination was not significantly higher compared with 22-42 days post-vaccination. Surveillance is ongoing despite wide confidence intervals for many outcomes.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2021)

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Editorial Material Pediatrics

Recurrence of Acute Myocarditis Temporally Associated with Receipt of the mRNA Coronavirus Disease 2019 (COVID-19) Vaccine in a Male Adolescent

Prashant K. Minocha et al.

JOURNAL OF PEDIATRICS (2021)

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Editorial Material Pediatrics

Myopericarditis After the Pfizer Messenger Ribonucleic Acid Coronavirus Disease Vaccine in Adolescents

Jenna Schauer et al.

JOURNAL OF PEDIATRICS (2021)

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Article Medicine, Legal

Deaths associated with newly launched SARS-CoV-2 vaccination (Comirnaty®)

Carolin Edler et al.

Summary: Since December 27, 2020, Germany has been using the mRNA vaccine from BioNTech/Pfizer. As of March 12, 2021, 286 deaths of vaccinated individuals have been registered, but no causal relationship between vaccination and death has been established.

LEGAL MEDICINE (2021)

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Letter Medicine, General & Internal

Myocarditis after Covid-19 mRNA Vaccination

Amanda K. Verma et al.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Medicine, General & Internal

Safety of the BNT162b2 mRNA Covid-19 Vaccine in a Nationwide Setting

Noam Barda et al.

Summary: The study found that after receiving the BNT162b2 vaccine, most adverse events were not associated with an increased risk, although there was a slight increase in the risk of myocarditis. On the other hand, infection with the Covid-19 virus significantly increased the risk of many serious adverse events.

NEW ENGLAND JOURNAL OF MEDICINE (2021)

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Article Pediatrics

COVID-19 Vaccination-Associated Myocarditis in Adolescents

Supriya S. Jain et al.

Summary: This study aimed to characterize the clinical presentation, short-term prognosis, and myocardial tissue changes in pediatric patients with C-VAM. The results showed that most patients had mild myocarditis and excellent short-term outcomes, with resolution of symptoms, arrhythmias, and ventricular dysfunction. Further studies are needed to understand the long-term implications of these myocardial tissue changes.

PEDIATRICS (2021)

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Editorial Material Medicine, General & Internal

Myocarditis after COVID-19 mRNA vaccines

T. Koizumi et al.

QJM-AN INTERNATIONAL JOURNAL OF MEDICINE (2021)

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Editorial Material Medicine, General & Internal

A spectrum of cardiac manifestations post Pfizer-BioNTech COVID-19 vaccination

E. Lee et al.

QJM-AN INTERNATIONAL JOURNAL OF MEDICINE (2021)

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Editorial Material Medicine, General & Internal

COVID-19 vaccination and dialysis patients: why the variable response

J-S Yen et al.

Summary: Uremia affects all parts of the immune system, making dialysis patients more susceptible to COVID-19 infection. Different factors such as vaccine types, doses and individual characteristics can lead to varying response rates in dialysis patients. Vaccination against COVID-19 in this population is crucial for global public health.

QJM-AN INTERNATIONAL JOURNAL OF MEDICINE (2021)

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Article Immunology

Myocarditis following COVID-19 vaccination-A case series

Dan Levin et al.

Summary: The incidence rate of myocarditis in the week following the second dose of the Pfizer-BioNTech COVID-19 vaccine was 5.07/100,000 vaccinated individuals, with all cases exhibiting mild disease and no sequela. Further investigation is needed to determine the true incidence rates and causality.

VACCINE (2021)

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Editorial Material Immunology

The Novel Platform of mRNA COVID-19 Vaccines and Myocarditis: Clues into the Potential Mechanism

George Lazaros et al.

VACCINE (2021)

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Article Immunology

Myocarditis following COVID-19 mRNA vaccination

Saif Abu Mouch et al.

Summary: This study reported six cases of myocarditis occurring shortly after BNT162b2 vaccination, all in young males with mild clinical course. All patients responded to the vaccine, and myocarditis post-BNT162b2 vaccination may be considered an adverse reaction.

VACCINE (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Possible Association Between COVID-19 Vaccine and Myocarditis Clinical and CMR Findings

Kirsten E. Shaw et al.

JACC-CARDIOVASCULAR IMAGING (2021)

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Editorial Material Medicine, General & Internal

Covid-19: Should we be worried about reports of myocarditis and pericarditis after mRNA vaccines?

Jacqui Wise

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Article Medicine, General & Internal

Characterising the background incidence rates of adverse events of special interest for covid-19 vaccines in eight countries: multinational network cohort study

Xintong Li et al.

Summary: This study highlights significant variations in the background incidence rates of 15 prespecified adverse events associated with covid-19 vaccines across different databases. Certain adverse events increase with age, while others are more prevalent in younger individuals. Meta-analytic estimates of adverse event rates have been classified by age and sex.

BMJ-BRITISH MEDICAL JOURNAL (2021)

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Review Biotechnology & Applied Microbiology

Landscape and progress of global COVID-19 vaccine development

Hui-Yao Huang et al.

Summary: This review depicts the current landscape of global COVID-19 vaccine research and development, summarizing key characteristics and available evidence on authorized vaccines for emergency use. It aims to provide insights for stakeholders to improve coordination in responding to the COVID-19 outbreak.

HUMAN VACCINES & IMMUNOTHERAPEUTICS (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Temporal Associations Between Immunization With the COVID-19 mRNA Vaccines and Myocarditis The Vaccine Safety Surveillance System Is Working

Ann Marie Navar et al.

JAMA CARDIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Myocarditis Following Immunization With mRNA COVID-19 Vaccines in Members of the US Military

Jay Montgomery et al.

Summary: This study investigated cases of myocarditis occurring in male patients within the US Military Health System after receiving mRNA COVID-19 vaccines between January and April 2021. A total of 23 male patients presented with acute chest pain within 4 days post-vaccination, with elevated troponin levels and findings consistent with myocarditis on imaging. The number of cases observed was higher than expected after a second dose of the vaccine among male military members.

JAMA CARDIOLOGY (2021)

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Editorial Material Cardiac & Cardiovascular Systems

Myocarditis Occurring After Immunization With mRNA-Based COVID-19 Vaccines

David K. Shay et al.

JAMA CARDIOLOGY (2021)

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Article Cardiac & Cardiovascular Systems

Association of Myocarditis With BNT162b2 Messenger RNA COVID-19 Vaccine in a Case Series of Children

Audrey Dionne et al.

Summary: This study reviewed comprehensive cardiac imaging results in children with myocarditis after receiving the BNT162b2 COVID-19 vaccine. Most cases of myocarditis occurred in boys after the second dose, and patients showed mild symptoms in short-term follow-up. Long-term risks of post-vaccination myocarditis remain unknown, necessitating larger studies for vaccination recommendations in this population.

JAMA CARDIOLOGY (2021)

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Article Immunology

Age- and Sex-Graded Data Evaluation of Vaccination Reactions after Initial Injection of the BNT162b2 mRNA Vaccine in a Local Vaccination Center in Germany

Manuela A. Hoffmann et al.

Summary: Vaccination against COVID-19 is crucial for older and chronically ill individuals. Research shows that people over 80 have a high tolerance to mRNA vaccines with low side effects, while women are more likely to experience adverse vaccination reactions. Consideration of age and gender differences is important for future vaccination strategies to achieve sufficient herd immunity.

VACCINES (2021)

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Article Immunology

Early Adverse Events between mRNA and Adenovirus-Vectored COVID-19 Vaccines in Healthcare Workers

Yu-Mi Wi et al.

Summary: The study found that early adverse events of BNT162b2 and AZD1222 vaccines were mostly mild to moderate and generally transient. Providing sufficient explanation of the expected adverse events of the vaccine would be beneficial for wider vaccination efforts.

VACCINES (2021)

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Article Cardiac & Cardiovascular Systems

Acute myocarditis after COVID-19 vaccination with mRNA-1273 in a patient with former SARS-CoV-2 infection

Tien Dung Nguyen et al.

Summary: A case of acute myocarditis following mRNA-1273 vaccination was reported, with the patient showing no history of SARS-CoV-2 infection but exhibiting myocardial inflammation and dysfunction. The strong temporal relation between vaccination and symptom onset suggested a potential side effect of mRNA-1273.

ESC HEART FAILURE (2021)

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Article Infectious Diseases

Perimyocarditis in Adolescents After Pfizer-BioNTech COVID-19 Vaccine

Eric Tano et al.

Summary: Pericarditis occurred in adolescents within 4 days of receiving the BNT162b2 vaccine. Further research is needed to understand the impact of the vaccine on adolescent heart health.

JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY (2021)

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Article Cardiac & Cardiovascular Systems

Case report: acute myocarditis following the second dose of mRNA-1273 SARS-CoV-2 vaccine

Prashant D. Tailor et al.

Summary: This case report describes symptomatic acute myocarditis following administration of the mRNA-1273 SARS-CoV-2 vaccine, with the patient presenting with symptoms 4 days after the second dose. Management with supportive therapy led to complete recovery of cardiac function and symptoms. Further research is needed to understand the mechanisms of mRNA vaccine-related myocarditis and potential long-term cardiovascular effects.

EUROPEAN HEART JOURNAL-CASE REPORTS (2021)

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Article Medicine, General & Internal

Isolated Tachycardia Presenting After Pfizer-BioNTech COVID-19 Vaccination

Charles Tate et al.

Summary: A 29-year-old woman presented with palpitations and rapid heart rate after receiving her second COVID-19 vaccination. This case, the first reported, resolved within 24 hours without any other symptoms, suggesting a benign and transient reaction to the Pfizer-BioNTech vaccine.

CUREUS JOURNAL OF MEDICAL SCIENCE (2021)

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Article Medicine, General & Internal

Cardiac Imaging of Acute Myocarditis Following COVID-9 mRNA Vaccination

In Cheol Kim et al.

Summary: A case of acute myocarditis following COVID-19 vaccination was reported, with the patient recovering well without any adverse events after treatment.

JOURNAL OF KOREAN MEDICAL SCIENCE (2021)

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Article Medicine, General & Internal

Unusual Presentation of Acute Perimyocarditis Following SARS-COV-2 mRNA-1237 Moderna Vaccination

Fatima Khogali et al.

Summary: This report presents a rare case of acute perimyocarditis and pericardial effusion following the second dose of Moderna COVID-19 vaccination in Qatar. The patient experienced various complications during hospitalization but eventually recovered and was discharged. This case highlights the potential development of cardiac issues post-vaccination.

CUREUS JOURNAL OF MEDICAL SCIENCE (2021)

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Article Cardiac & Cardiovascular Systems

Acute myocarditis after the second dose of SARS-CoV-2 vaccine: Serendipity or atypical causal relationship?

Alberto Cereda et al.

ANATOLIAN JOURNAL OF CARDIOLOGY (2021)

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Article Immunology

Acute myocarditis associated with anti-COVID-19 vaccination

Alon Nevet

Summary: Novel anti-coronavirus disease 2019 mRNA vaccines are being rapidly distributed worldwide, raising concerns about potential life-threatening adverse reactions. Three young male patients developed acute myocarditis shortly after receiving the second dose of the BNT162b2 vaccine, a rare occurrence not previously reported with adjuvant-free vaccines. Timely diagnosis and treatment of auto-inflammatory vaccine-related complications are crucial, and further research is needed to understand the significance and underlying molecular mechanisms of this phenomenon.

CLINICAL AND EXPERIMENTAL VACCINE RESEARCH (2021)

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Article Infectious Diseases

Acute myocarditis following administration of BNT162b2 vaccine

Mhd Baraa Habib et al.

Summary: The widespread use of vaccines has been associated with rare but serious complications in adults, leading to global concern. This case study highlights a young male patient who developed acute myocarditis three days after receiving the second dose of the BNT162b2 vaccine.

IDCASES (2021)

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Article Medicine, General & Internal

Myocarditis and Other Cardiovascular Complications of the mRNA-Based COVID-19 Vaccines

Mahesh K. Vidula et al.

Summary: This case series describes cardiovascular complications after receiving mRNA-based COVID-19 vaccines, including myocarditis, stress cardiomyopathy, and pericarditis. Patients presented with symptoms such as chest pain, dyspnea, and elevated inflammatory markers, along with abnormal cardiac indicators in tests.

CUREUS JOURNAL OF MEDICAL SCIENCE (2021)

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Article Medicine, General & Internal

Untimely Myocardial Infarction or COVID-19 Vaccine Side Effect

Zachary Boivin et al.

Summary: Healthcare providers should be cautious about correlating adverse outcomes with vaccination without proper data support, and be prepared to address patient inquiries based on such reports. Research on the topic should be conducted carefully without exaggerated claims, and additional screenings may be necessary for older adults before COVID-19 vaccination if serious side effects are reported.

CUREUS JOURNAL OF MEDICAL SCIENCE (2021)

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Review Cardiac & Cardiovascular Systems

Systematic Review of COVID-19 Related Myocarditis: Insights on Management and Outcome

Khalid Sawalha et al.

Summary: COVID-19 infection can lead to myocarditis, with a male predominance and a median age of 50.4 years in reported cases. While most patients did not have previously identified comorbid conditions, hypertension was the most prevalent. Elevated troponin levels were common, and echocardiography revealed reduced function in 60% of cases. Most patients survived to discharge, with a high percentage of those receiving steroids also surviving. Treatment approaches for COVID-19 myocarditis are still evolving and should be individualized until more research is conducted.

CARDIOVASCULAR REVASCULARIZATION MEDICINE (2021)

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Review Cardiac & Cardiovascular Systems

A systematic review of ECG findings in patients with COVID-19

Esmaeil Mehraeen et al.

INDIAN HEART JOURNAL (2020)

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Article Cardiac & Cardiovascular Systems

Cardiac Magnetic Resonance Assessment of Myocarditis

Matthias G. Friedrich et al.

CIRCULATION-CARDIOVASCULAR IMAGING (2013)

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Cardiac complications following mRNA COVID-19 vaccines: A systematic review of case reports and case series

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