A case of ST segment elevation myocardial infarction within 24 h of a third dose of COVID-19 mRNA vaccine

Although coronavirus disease 2019 (COVID-19) vaccination is known to carry a slight risk of myocarditis and pericarditis, it remains unclear whether it has any impact on coronary artery disease. Here we present a case without particular thrombotic diathesis with a diagnosis of ST segment elevation acute myocardial infarction (STEMI) 19 h after a third dose of a COVID-19 mRNA vaccine. A primary percutaneous coronary intervention procedure for occluded right coronary artery with thrombus aspiration alone was successful in this patient. However, the relationship between STEMI and COVID-19 mRNA vaccination is uncertain, and additional studies to validate thrombogenetic effects of COVID-19 mRNA vaccines are needed. This case was helpful in distinguishing STEMI from myocarditis and pericarditis, which are recognized rare cardiac side effects of COVID-19 vaccination. It is important not to hesitate to perform coronary angiography procedures to rule out the possibility of STEMI occurrence, as in this case.