Sex: F
Vaccine: COVID19
Symptoms: Cardiac stress test, Computerised tomogram thorax, Investigation, Magnetic resonance imaging heart, Myocarditis
Clinical narrative: A Case of Post-Vaccine Myocarditis Mimicking Long Covid; This is a literature report for the following literature source(s): A 59-year-old female patient received BNT162b2 (BNT162B2), as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "mild COVID infection" (unspecified if ongoing). The patient's concomitant medications were not reported. Vaccination history included: Bnt162b2 (Dose 1, single), for Covid-19 immunisation, reaction(s): "intermittent chest discomfort several days after receiving her first dose of the Pfizer-BioNTech COVID-19 vaccine", "diminished exercise capacity", "unexplained fatigue", "found to have dynamic troponin elevation peaking at 177 ng/L". The following information was reported: MYOCARDITIS (hospitalization, medically significant, life threatening), outcome "recovered", described as "A Case of Post-Vaccine Myocarditis Mimicking Long Covid". The patient underwent the following laboratory tests and procedures: Cardiac stress test: failed to demonstrate an etiology, notes: after dose 1; Computerised tomogram thorax: failed to demonstrate an etiology, notes: after dose 1; ambulatory cardiac monitoring: failed to demonstrate an etiology, notes: after dose 1; Magnetic resonance imaging heart: revealing edema in the basal lateral, notes: wall and late gadolinium enhancement in a subepicardial distribution, suggestive of myocardial inflammation; performed two weeks later, notes: showed complete resolution of myocardial edema with residual subepicardial LGE in the basal lateral wall consistent with prior myocarditis; Specialist consultation: results unknown; Troponin: 177 ng/L, notes: dynamic troponin elevation peaking. Therapeutic measures were taken as a result of myocarditis.  Clinical course: Patient subsequently received second dose of the COVID-19 vaccine which resulted in worsening cardiopulmonary symptoms that persisted over the next several months. Her symptoms were initially attributed to long COVID, and she was provided supportive care and  for anxiety. After reevaluation in the Cardiology clinic, the patient underwent cardiac MRI revealing edema in the basal lateral wall and late gadolinium enhancement in a subepicardial distribution, suggestive of myocardial inflammation. She was treated with prednisone 50 mg daily and colchicine 0.6 mg twice daily resulting in resolution of chest pain. A repeat MRI was performed two weeks later showed complete resolution of myocardial edema.; Sender's Comments: Based on available information and the temporal association, a possible contributory role of Comirnaty vaccine cannot be excluded for the reported event  of "MYOCARDITIS". The impact of this report on the benefit/risk profile of the Pfizer drug 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.