Sex: M
Vaccine: COVID19
Symptoms: Blood pressure diastolic, C-reactive protein, Echocardiogram, Ejection fraction, Electrocardiogram
Clinical narrative: Myocarditis; Myocardial edema; Pericardial effusion; This is a literature report.  A 17-year-old male patient received bnt162b2 (BNT162B2) (Batch/Lot number: unknown) as dose 2, single and (Batch/Lot number: unknown) as dose 1, single for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: MYOCARDITIS (hospitalization, medically significant), outcome "recovering", described as "Myocarditis"; MYOCARDIAL OEDEMA (hospitalization, medically significant), outcome "recovering", described as "Myocardial edema"; PERICARDIAL EFFUSION (hospitalization, medically significant), outcome "recovering", described as "Pericardial effusion". The patient was hospitalized for myocarditis, myocardial oedema, pericardial effusion (hospitalization duration: 4 day(s)). The events "myocarditis", "myocardial edema" and "pericardial effusion" were evaluated at the emergency room visit. The patient underwent the following laboratory tests and procedures: blood pressure diastolic: 62, notes: mL/m2; c-reactive protein: 1.40 mg/dl; echocardiogram: normal, notes: Biventricular size, Biventricular function; ejection fraction: 62 %; 55 %; electrocardiogram: sinus bradycardia; laboratory test: yes; yes; negative; 79, notes: ml/m2; magnetic resonance imaging heart: unknown results; troponin: 1.38 ng/ml. Therapeutic measures were taken as a result of myocarditis, myocardial oedema, pericardial effusion.  Clinical course: Of 52 patients without known prior SARS-CoV-2 infection who underwent cardiac MRI during the study period, five underwent MRI for suspected myocarditis after recent COVID-19 mRNA vaccination. All five patients were male patients ranging in age from 16 to 19 years (mean, 17.2 ± 1.0 [SD] years) who presented within 4 days of receiving the second dose of a COVID-19 mRNA vaccine. Troponin levels were elevated in all patients (mean peak troponin I value, 6.82 ± 4.13 ng/mL). Alternate possible causes of myocarditis were deemed clinically unlikely on the basis of medical history, physical examination findings, myocarditis viral panel, and toxicology screening. Cardiac MRI findings were consistent with myocarditis in all five patients on the basis of the Lake Louise criteria, including early gadolinium enhancement and late gadolinium enhancement (LGE) in all patients and corresponding myocardial edema in four patients. All five patients had a favorable hospital course and were discharged from the hospital in stable condition with improved or resolved symptoms after hospitalization (mean length of hospital stay, 4.8 days). Two patients underwent repeat cardiac MRI that showed persistent, although decreased, LGE. Three patients reported mild intermittent self-resolving chest pain after hospital discharge, and two patients had no recurrent symptoms after discharge. CONCLUSION. In this small case series, all patients with myocarditis after COVID-19 vaccination were male adolescents and had a favorable initial clinical course. All patients showed cardiac MRI findings typical of myocarditis from other causes. LGE persisted in two patients who underwent repeat MRI. These observations do not establish causality. CLINICAL IMPACT. Radiologists should be aware of a possible association of COVID-19 mRNA vaccination and myocarditis and recognize the role of cardiac MRI in the assessment of suspected myocarditis after COVID-19 vaccination.; Sender's Comments: Based on the current limited available information and the drug-event temporal association, a possible contributory role of the suspect product BNT162B2 to the development of events myocarditis, myocardial oedema and pericardial effusion cannot be excluded.   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) : US-PFIZER INC-202200355287 Same article/ drug/event and different patient