Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Myalgia, Nausea, Procalcitonin, Red blood cell sedimentation rate, SARS-CoV-2 antibody test
Clinical narrative: Takotsubo Cardiomyopathy; coronary artery disease; lightheadedness; myalgia; nausea; fatigue; headache; This literature-non-study case was reported in a literature article and describes the occurrence of STRESS CARDIOMYOPATHY (Takotsubo Cardiomyopathy) and CORONARY ARTERY DISEASE (coronary artery disease) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. The occurrence of additional non-serious events is detailed below.   LITERATURE REFERENCE: COVID-19 VaccineAssociated Takotsubo Cardiomyopathy. 2021    The patient's past medical history included Nephrectomy in 2000. Concurrent medical conditions included Asthma, Glaucoma, Hyperlipidemia, Renal cell carcinoma and Lightheadedness (Transthoracic echocardiography (TTE) 2 months before because of this, with no findings regarding the ones from the TTE during hospitalization). Concomitant products included MULTIVITAMINS [VITAMINS NOS], LATANOPROST and TIMOLOL for an unknown indication.    On an unknown date, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date, the patient experienced STRESS CARDIOMYOPATHY (Takotsubo Cardiomyopathy) (seriousness criteria hospitalization and medically significant), CORONARY ARTERY DISEASE (coronary artery disease) (seriousness criterion hospitalization), DIZZINESS (lightheadedness), MYALGIA (myalgia), NAUSEA (nausea), FATIGUE (fatigue) and HEADACHE (headache). The patient was treated with ACETYLSALICYLIC ACID (ASPIRIN (E.C.)) ongoing since an unknown date at an unspecified dose and frequency; ATORVASTATIN ongoing since an unknown date at an unspecified dose and frequency; LISINOPRIL ongoing since an unknown date at an unspecified dose and frequency and METOPROLOL SUCCINATE ongoing since an unknown date at an unspecified dose and frequency. At the time of the report, STRESS CARDIOMYOPATHY (Takotsubo Cardiomyopathy), DIZZINESS (lightheadedness), MYALGIA (myalgia), NAUSEA (nausea), FATIGUE (fatigue) and HEADACHE (headache) had resolved and CORONARY ARTERY DISEASE (coronary artery disease) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Angiogram: abnormal (abnormal) showed only mild coronary artery disease. On an unknown date, Antinuclear antibody: normal (normal) normal. On an unknown date, Blood count: normal (normal) normal. On an unknown date, Blood creatinine: normal (normal) normal. On an unknown date, Blood lactate dehydrogenase: normal (normal) normal. On an unknown date, Blood urea: normal (normal) normal. On an unknown date, C-reactive protein: normal (normal) normal. On an unknown date, Chest X-ray: normal (normal) did not show any underlying cardiopulmonary process.. On an unknown date, Coxsackie virus test: negative (Negative) negative. On an unknown date, Echocardiogram: abnormal (abnormal) showed a reduced left ventricular ejection fraction of 35% with hypokinesis of the mid and distal segments and normal contraction of the basal segments with normal right ventricular function and resolution with ef of 60%65% (Inconclusive) resolution with EF of 60%65% with no wall-motion abnormalities (5 week follow up).. On an unknown date, Electrocardiogram: abnormal (abnormal) showed evolving ST-T changes suggestive of inferolateral ischemia. On an unknown date, Fibrin D dimer: normal (normal) normal and normal (normal) normal. On an unknown date, HIV test: negative (Negative) negative. On an unknown date, Heart rate: 40´s, bradycardia (abnormal) 40´s, bradycardia. On an unknown date, Influenza A virus test: negative (Negative) negative. On an unknown date, Influenza B virus test: negative (Negative) negative. On an unknown date, Procalcitonin: normal (normal) normal. On an unknown date, Red blood cell sedimentation rate: normal (normal) normal. On an unknown date, SARS-CoV-2 antibody test: negative (Negative) negative. On an unknown date, SARS-CoV-2 test: negative (Negative) negative. On an unknown date, Serum ferritin: normal (normal) normal. On an unknown date, Thyroid function test: normal (normal) normal. On an unknown date, Troponin: 0.57 ng/dl (abnormal) was elevated to 0.57 ng/dL (normal , 0.034 ng/dL).     The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown.   For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered STRESS CARDIOMYOPATHY (Takotsubo Cardiomyopathy), CORONARY ARTERY DISEASE (coronary artery disease), DIZZINESS (lightheadedness), MYALGIA (myalgia), NAUSEA (nausea), FATIGUE (fatigue) and HEADACHE (headache) to be possibly related.    Patient who presented with a chief complaint of chest pressure. She was in good health 3 days before when she received her first dose of the mRNA-1273 SARS-CoV-2 vaccine. However, later that day, she began to experience chest pressure associated with shortness of breath and lightheadedness. She did not have vomiting, diaphoresis, palpitation, fever, or chills. The findings were consistent with takotsubo cardiomyopathy. These findings were new compared with TTE 2 months before, which was performed as a part of evaluation for lightheadedness. She was a clinical social worker and was working remotely. She denied any recent emoti  onal or physical stress. She denied any use of herbal supplements, recreational drugs, or alcohol. She did not have any known allergies to food, drugs, or vaccines. A plan for close follow-up and repeat echocardiogram was arranged.   Therapy for the events was not reported.  Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.  The event mild coronary artery disease is probably a finding during the work up for the Stress cardiomyopathy and was generated before vaccination, given the short latency between the first dose of the vaccine and the onset of this event. Patient´s comorbidities are confounders for the case.   Most recent FOLLOW-UP information incorporated above includes: On 07-Sep-2021: Follow up received by safety 08-Sep-2021 included an email from the team with an abstract and no new information.; Sender's Comments: Based on the current available information and temporal association between the use of the product and the start date of the events, a causal relationship cannot be excluded.  The event mild coronary artery disease is probably a finding during the work up for the Stress cardiomyopathy and was generated before vaccination, given the short latency between the first dose of the vaccine and the onset of this event. Patient´s comorbidities are confounders for the case.