Fulminant myocarditis with complete atrioventricular block after mRNA COVID-19 vaccination: A case report

A 71-year-old man was transferred urgently to our hospital after collapsing near his home post the first shot of the BNT162b2 coronavirus disease 2019 vaccine (Pfizer-BioNTech, Comirnaty®). Immediately after arrival at our hospital, cardiac arrest due to complete atrioventricular block with no ventr...

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Detalles Bibliográficos
Autores principales: Onishi, Naoaki, Konishi, Yuki, Kaneko, Toshiyuki, Maekawa, Naohiro, Suenaga, Akihira, Nomura, Shinnosuke, Kobayashi, Takayasu, Kyo, Shokan, Okabayashi, Marie, Higami, Hirooki, Oi, Maki, Higashitani, Nobuya, Saijo, Sayaka, Nakazeki, Fumiko, Oyamada, Naofumi, Jinnai, Toshikazu, Okuno, Tomoko, Shirase, Tomoyuki, Kaitani, Kazuaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japanese College of Cardiology 2023
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9906563/
https://www.ncbi.nlm.nih.gov/pubmed/36779079
http://dx.doi.org/10.1016/j.jccase.2023.01.004
Descripción
Sumario:A 71-year-old man was transferred urgently to our hospital after collapsing near his home post the first shot of the BNT162b2 coronavirus disease 2019 vaccine (Pfizer-BioNTech, Comirnaty®). Immediately after arrival at our hospital, cardiac arrest due to complete atrioventricular block with no ventricular escaped beats was observed on electrocardiogram. Echocardiography showed preserved left ventricular ejection fraction, however, diffuse severe hypokinesia was revealed after 3 weeks, and he died 3 months after admission because of worsening heart failure. An autopsy examination revealed eosinophilic myocarditis or hypersensitivity myocarditis with extensive fibrosis and widespread myocardial dropout throughout the heart. LEARNING OBJECTIVE: 1. Severe myocarditis occurs extremely rarely after mRNA coronavirus disease 2019 (COVID-19) vaccination. 2. Myocarditis after mRNA COVID-19 vaccination might cause complete atrioventricular block, followed by a course of decreased left ventricular ejection fraction. 3. Histologically, severe myocarditis after mRNA COVID-19 vaccination seems to present as fulminant necrotizing eosinophilic myocarditis or hypersensitivity myocarditis.

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