Age: 42.0
Sex: M
Vaccine: COVID19
Symptoms: Chest pain, Ejection fraction, Electrocardiogram, Percutaneous coronary intervention, SARS-CoV-2 test
Clinical narrative: Acute Myocardial Infarction; Injection site pain from the vaccination but was otherwise asymptomatic; Chest pain; Shoulder pain; This literature-non-study case was reported in a literature article and describes the occurrence of ACUTE MYOCARDIAL INFARCTION (Acute Myocardial Infarction), VACCINATION SITE PAIN (Injection site pain from the vaccination but was otherwise asymptomatic), CHEST PAIN (Chest pain) and ARTHRALGIA (Shoulder pain) in a 42-year-old male patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination.   LITERATURE REFERENCE: Acute myocardial infarction within 24 hours after COVID-19 vaccination. 2021;S0002-9149(21):00631-7     The patient's past medical history included Percutaneous coronary intervention (The patient had no more chest pain after PCI  and remained hemodynamically stable) and Catheterization arterial. Family history included Coronary artery disease since an unknown date. Concurrent medical conditions included Hyperlipidemia.    On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) 1 dosage form. On an unknown date, the patient experienced ACUTE MYOCARDIAL INFARCTION (Acute Myocardial Infarction) (seriousness criteria hospitalization and medically significant), VACCINATION SITE PAIN (Injection site pain from the vaccination but was otherwise asymptomatic) (seriousness criterion hospitalization), CHEST PAIN (Chest pain) (seriousness criterion hospitalization) and ARTHRALGIA (Shoulder pain) (seriousness criterion hospitalization). At the time of the report, ACUTE MYOCARDIAL INFARCTION (Acute Myocardial Infarction) and VACCINATION SITE PAIN (Injection site pain from the vaccination but was otherwise asymptomatic) outcome was unknown and CHEST PAIN (Chest pain) and ARTHRALGIA (Shoulder pain) was resolving.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Angiocardiogram: abnormal (abnormal) revealed complete occlusion of the LC artery and LC 90% (abnormal) CT coronary angiography showed a large amount of noncalcified plaque in the proximal LC artery, resulting in complete focal occlusion just proximal to the origin of first obtuse marginal artery. Coronary angiography in the catheterization laboratory revealed a 90% stenosis in the proximal LC artery with TIMI 1 flow.. On an unknown date, Angiogram: final (Inconclusive) angiogram showed an excellent result with TIMI III flow. On an unknown date, Body mass index: 42.8 (Inconclusive) 42.8 kg/m2. On an unknown date, Ejection fraction: 50 (Inconclusive) 50%. On an unknown date, Electrocardiogram: cardiac ultrasound showed (abnormal) Cardiac ultrasound showed left ventricular ejection fraction of 60%, with hypokinetic inferior and inferolateral walls.. On an unknown date, Percutaneous coronary intervention: LC (Inconclusive) LC. On an unknown date, SARS-CoV-2 test: negative (Negative) Negative. On an unknown date, Troponin: 1763 ng/l (Inconclusive) 1763 ng/L and elevated (Inconclusive) elevated Troponin with no significant ECG change. On an unknown date, Troponin I (0-47): 9,200 ng/l (abnormal) 9,200 ng/L. On an unknown date, Troponin T (0-14): 723  ng/l (High) high-sensitivity troponin-T rose was from 723 ng/L to 1763 ng/L.     The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular) was unknown.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Intramuscular), the reporter considered ACUTE MYOCARDIAL INFARCTION (Acute Myocardial Infarction), VACCINATION SITE PAIN (Injection site pain from the vaccination but was otherwise asymptomatic), CHEST PAIN (Chest pain) and ARTHRALGIA (Shoulder pain) to be possibly related.    Concomitant medications were not provided by the reporter.  The patient presented with 4 days of chest and shoulder pain. Symptoms started the night after he had his first dose of COVID-19 vaccine (mRNA-1273). He woke up from sleep with sharp, intense chest pain that radiated to the jaw. Symptoms slightly improved but remained for 4 more days, and he finally presented to an outside hospital. Interval (hours) between vaccine injection and Chest pain was less than 12 hours. Emergency PCI of the LC artery was performed. A workhorse wire was used to cross the lesion. The lesion was dilated with a 2.5 mm x 12 mm semi compliant balloon. A 3.0 mm x 18 mm zotarolimus eluting stent was deployed to treat the lesion and was optimized with a 3.5 mm x 12 mm noncompliant balloon. He was initiated on guideline-directed medical therapy and discharged home 2 days later.  Company Comment: Based on the current available information and temporal association between the use of the product and the start of events (according to information in the article), a causal relationship cannot be excluded. Patient's age and previous history of hyperlipidemia and prior coronary artery disease can be confounders.   This case was linked to MOD-2021-290625 (Patient Link).; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start of events (according to information in the article), a causal relationship cannot be excluded. Patient's age and previous history of hyperlipidemia and prior coronary artery disease can be confounders.