SHM Converge Scientific Abstract ePoster Gallery-Myocarditis Post Mrna Vaccination for Covid-19

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This case report describes a 28-year-old man who developed chest pain four days after receiving his second Pfizer-BioNTech mRNA COVID-19 vaccine dose. He had no prior SARS-CoV-2 infection, no known exposure, and no viral prodrome. On presentation, his vital signs and physical examination were normal. EKG showed normal sinus rhythm with nonspecific ST-T changes, and chest X-ray was unremarkable.<br /><br />Laboratory testing revealed markedly elevated troponin I (9.9 ng/mL, peaking at 11.8 ng/mL) along with elevated inflammatory markers, including CRP, LDH, CK, and ESR. Echocardiogram showed normal left ventricular function with an ejection fraction of 60% and no regional wall motion abnormalities. SARS-CoV-2 RT-PCR testing was negative. Based on the timing after vaccination, clinical findings, and exclusion of other likely causes, the authors diagnosed post-mRNA COVID-19 vaccination myocarditis. His chest pain improved after a single dose of ibuprofen, and he was discharged after overnight observation.<br /><br />The discussion notes that myocarditis has been reported after COVID-19 vaccination, especially in young males, often after the second dose. Similar rare cases have been seen with other vaccines such as smallpox and influenza. The exact mechanism is unclear, but hypersensitivity myocarditis is suspected. Cardiac MRI and biopsy can show typical myocarditis findings, though the condition generally has a good prognosis.<br /><br />The authors emphasize that clinicians should consider myocarditis in adolescents and young adults who present with chest pain after COVID-19 vaccination. In many cases, diagnosis may rely on history, labs, and basic imaging rather than extensive costly testing.

Asset Subtitle

Abhishek Matta

Meta Tag

Author List Abhishek Matta, Danielle Matta, Dinesh Bande

Category Clinical Vignettes

Concept Myocarditis

Concept mRNA COVID-19 Vaccine

Concept Chest Pain

Concept Troponin

Concept Inflammatory Markers

Distinguished Non-Finalist

Presenter Organization Sanford Health/University of North Dakota School of Medicine

Presenting Author Abhishek Matta

Track Adult

Keywords

myocarditis

COVID-19 vaccination

Pfizer-BioNTech

chest pain

troponin elevation

young male

inflammatory markers

second dose

cardiac MRI

post-vaccination myocarditis

Myocarditis

mRNA COVID-19 Vaccine

Chest Pain

Troponin

Inflammatory Markers