Characteristics of Teenagers Presenting with Chest Pain after COVID-19 mRNA Vaccination

In this study, we evaluated the clinical and radiological manifestations of teenagers presenting with chest pain after coronavirus disease 2019 (COVID-19) messenger RNA (mRNA) vaccination. We retrospectively enrolled 61 teenage patients, aged 13 to 19 years, who underwent echocardiography and cardiac magnetic resonance imaging (CMR) for chest pain after COVID-19 mRNA vaccination, from November 2021 to April 2022. Medical records, laboratory results, echocardiographic, and CMR findings were analyzed. The mean age of the participants was 14.4 & PLUSMN; 1.9 years, with a male:female ratio of 28:33. Among the sixty-one patients with chest pain after COVID-19 vaccination, only two (3.3%) were diagnosed as confirmed myocarditis, and almost all of them recovered with conservative treatments. However, on CMR, 24 (39.3%) presented with mild myocardial abnormalities; 22 (36.1%) showed myocardial edema, and 19 (31.1%) were found to have a myocardial injury. Multivariate logistic analyses revealed that older age and female sex were significantly associated with myocardial abnormalities. In teenagers who present with chest pain after COVID-19 mRNA vaccination, confirmed myocarditis is uncommon. However, myocardial abnormalities on CMR might occur frequently, and females in their late teens might be more vulnerable to myocardial abnormalities.

Automated summary

This study evaluated the clinical and radiological manifestations of teenagers with chest pain after COVID-19 mRNA vaccination. Among the 61 patients, only 3.3% were diagnosed with confirmed myocarditis, while myocardial abnormalities were observed in 39.3% of patients on CMR. Female sex and older age were associated with these abnormalities. The findings suggest that myocarditis is uncommon, but myocardial abnormalities may occur frequently in teenagers after COVID-19 vaccination.