Sex: M
Vaccine: COVID19
Symptoms: Left ventricular end-diastolic pressure, Myopericarditis
Clinical narrative: COVID-19 vaccine induced fulminant myopericarditis; The initial case was missing the following minimum criteria: unidentified patients. Upon receipt of follow-up information on (07Mar2023), this case now contains all required information to be considered valid.   This is a literature report for the following literature source(s): "COVID-19 VACCINE INDUCED FULMINANT MYOPERICARDITIS".  A 59-year-old male patient received BNT162b2 (BNT162B2), as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Covid-19 vaccine (Dose 1, Manufacturer unknown), for COVID-19 immunisation. The following information was reported: MYOPERICARDITIS (death, hospitalization, medically significant), outcome "fatal", described as "COVID-19 vaccine induced fulminant myopericarditis". The patient underwent the following laboratory tests and procedures: Angiocardiogram: no disease, severe global hypokinesis; Echocardiogram: effusion, LV free wall edema; Ejection fraction: 30 %; 15 %; Electrocardiogram: hypotensive with inferolateral ST elevation; Imaging procedure: strongly suggests fulminant myopericarditis, notes: related to inflammatory response from COVID-19 vaccine; Left ventricular end-diastolic pressure: 19 mmHg. The patient date of death was unknown. Reported cause of death: "fulminant myopericarditis related to inflammatory response from COVID-19 vaccine", "All attempts to mitigate inflammation with steroids, indomethacin, colchicine, and immunoglobulin were futile". No autopsy was performed. Course of events: A case at a rural community hospital in which all available treatments were utilized. Lack of access to tertiary care contributed to patient mortality. Patient presented with chest pain and dyspnea after his second dose of the BNT162b2 COVID-19 mRNA vaccine. All attempts to mitigate inflammation with steroids, indomethacin, colchicine, and immunoglobulin were futile. Efforts to manage cardiogenic shock included all available measures at author's facility including vasopressors and an Impella CP catheter. Transfer for mechanical circulatory support was unsuccessful due to bed shortage at tertiary hospitals, so he was transitioned to hospice and expired. Family declined autopsy, but the clinical picture and imaging strongly suggests fulminant myopericarditis related to inflammatory response from COVID-19 vaccine.; Sender's Comments: A contributory role of BNT162B2 to the event myopericarditis cannot be fully excluded based on presumed temporal relationship, lack of reported alternative explanation at this time and since it is part of the product safety profile. The absence of clinical details precludes a more meaningful assessment. 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.; Reported Cause(s) of Death: All attempts to mitigate inflammation with steroids, indomethacin, colchicine, and immunoglobulin were futile; fulminant myopericarditis related to inflammatory response from COVID-19 vaccine