Sex: M
Vaccine: COVID19
Symptoms: Echocardiogram, Ejection fraction, Electrocardiogram, Electrocardiogram ambulatory, Fibrin D dimer
Clinical narrative: perimyocarditis/self-resolving chest pain/intermittent, non-radiating, retrosternal pain; This is a literature report. This author reported similar events for eight patients. This is the seventh of eight reports.  A 15-year-old (also reported as 15.2-year-old) male with no past medical history presented with a 2-day history of intermittent, non-radiating, retrosternal pain. He denied recent fever, shortness of breath, or recent illness. No history of SARS-CoV-2 infection. Three days prior to presentation, the patient received his second BNT162b2 vaccine. Upon further interviewing, he reported 2 episodes of self-resolving chest pain 3 days after the first dose of the BNT162b2 vaccine of unclear significance given he did not seek medical care. Chest X-ray was normal. Initial laboratories were unremarkable aside from elevated CPK-MB level of 44.5 ng/mL with a peak troponin level of 22.05 ng/mL. ECG showed intraventricular conduction delay with transient ST-segment depression. TTE showed no structural abnormalities, qualitatively normal LVSF, and no significant pericardial effusion. A 24-hour Holter showed 13 multiform PVCs, including 1 couplet. Patient was managed with ibuprofen with resolution of pain on day 3 of admission. RPP was negative, and Mycoplasma IgG and IgM were positive; however, nasopharyngeal PCR for Mycoplasma was negative. The decision was made to treat with azithromycin for Mycoplasma infection. Patient reported chest pain after first vaccine although he did not seek medical care.  Demographic and clinical characteristics: Body mass index (kg/m2) 17.3. No Past medical history (PMH). History of prior COVID-19 infection No. BNT162b2 vaccine dose #2. Days between vaccine and symptom onset 3. Length of stay (hours) 65.  Laboratories: White blood cell count (Ref: 5-10) 8.9; Peak troponin-I (Ref: 0.00-0.08 ng/mL) 22.05; Discharge troponin-I (Ref: 0.00-0.08 ng/mL) 11.56; CKMB (Ref:0-3.5ng/mL) 44.5; d-dimer (Ref: 0.27-0.41 mmg/mL) 0.11. COVID-19 testing: SARS-CoV-2 PCR Negative; SARS-CoV-2 nucleocapsid IgG Negative  EKG findings Intraventricular conduction delay, transient ST-segment depression.  Imaging Chest radiograph (cardiopulmonary findings) Negative; Left ventricular ejection fraction on ECHO 60; Pericardial effusion present No. Treatment/intervention: IVIG (intravenous immunoglobulin) No; Scheduled NSAIDs (nonsteroidal anti-inflammatory drugs) Yes.  DISCUSSION Herein described is the first case series from a single institution of 8 adolescent males with a diagnosis of perimyocarditis in the setting of recent BNT162b2 vaccination with no other identifiable cause.  No follow-up attempts are needed, information about batch number cannot be obtained.; Sender's Comments: A contributory role of BNT162B2 to the event perimyocarditis cannot be excluded based on the plausible temporal relationship, product safety profile and lack of reported alternative explanation at this time. This case will be reassessed if additional information becomes available.  The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to regulatory authorities, Ethics Committees, and Investigators, as appropriate.,Linked Report(s) : PFIZER INC-202101133568 Same article/drug/event; different patient