Sex: M
Vaccine: COVID19
Symptoms: Myopericarditis, Oxygen saturation, Physical examination, Pulmonary function test, Respiratory rate
Clinical narrative: history of recent vaccination with supporting laboratory and ECG findings, myopericarditis secondary to SARS-CoV-2 vaccination was suspected; This is a literature report for the following literature source(s): cardiovascular journal, 2021; Vol:17(3), pgs:13-17, DOI:10.14797/mdcvj.847.  A 29-year-old male patient received BNT162b2 (BNT162B2), as dose 2, single (Batch/Lot number: unknown) for covid-19 immunization. The patient's relevant medical history and concomitant medications were not reported. Vaccination history included: Bnt162b2 (DOSE 1, SINGLE), for COVID-19 immunization. The following information was reported: MYOPERICARDITIS (medically significant), 4 days after the suspect product(s) administration, outcome "recovered", described as "history of recent vaccination with supporting laboratory and ECG findings, myopericarditis secondary to SARS-CoV-2 vaccination was suspected". The patient underwent the following laboratory tests and procedures: Blood creatinine (39-308): 386 IU/l; Blood pressure measurement: 122/75 mmHg; Chest X-ray: showed no acute processes and an unremarkable medi, notes: astinum; Echocardiogram: which revealed no wall motion abnormalities, norma, notes: l left ventricular diastolic function, and an estimated ejection fraction of 60%; Ejection fraction: 60 %; Electrocardiogram: suggested pericarditis; abnormal; Myopericarditis was strongly suggested based on pa, notes: tient presentation; revealed improvement in diffuse ST segment; reported sinus bradycardia with a rate of 56 beats, notes: per minute, normal axis of deviation; Electrocardiogram QRS complex (80-100): 98, notes: Units: ms; Electrocardiogram QT interval (normal high range 440): 370, notes: Units: ms; Electrocardiogram ST segment: elevation throughout; Full blood count: normal limits; Haemodynamic test: stable; Heart rate: 61, notes: Units: beats per minute; cardiac exam: revealed a regular rate and rhythm without murmurs, notes: clicks, or rubs; elevated; PR interval (120-200): 128, notes: Units: ms; Laboratory results: from the comprehensive metabolic panel and complet, notes: e blood count with differential were within normal limits; performed at the appointment revealed a return to, notes: baseline for all markers, including serum creatine kinase and troponin; Metabolic function test: normal limits; Oxygen saturation: 99 %, notes: on room air; physical examination: was unremarkable; Pulmonary function test: revealed equal breath sounds auscultated bilateral, notes: ly; Respiratory rate: 16, notes: Units: breaths per minute; Troponin (normal high range 0.04): 5.97 ng/ml; elevated; 13.47 ng/ml, notes: peaked; Weight: less than 70 kg. Therapeutic measures were taken as a result of myopericarditis.  Clinical course: The patient with no past medical history presented to the emergency department (ED) with chest pain for the past day. The patient initially attributed the pain to gastroesophageal reflux but failed to alleviate his symptoms with over-the-counter medications. Over several hours, the patient reported that the vague chest pain became sharp, substernal, and without radiation, prompting him to go to the ED. He stated that he was in good health, required no medications, and received his second Pfizer-BioNTec vaccination approximately 4 days before the onset of chest pain. He denied a history of recent illness, fevers, chills, palpitations, diaphoresis, syncope, or a ripping or tearing sensation in his chest. He has no history of thromboembolism, hypercoagulability disorders, recent surgery, nor periods of immobilization. The patient also denied tobacco and illicit drug use or a family history of coronary artery disease. The cardiology team was consulted and the patient was admitted to the general medical floor. Other potential diagnoses in the differential included myocarditis, cardiac injury, and ST-elevated myocardial infarction. The patient received 162 mg of aspirin in the emergency department. He was started on 325 mg of aspirin three times daily and 0.6 mg colchicine twice a day for 1 day, with 0.6 mg once a day afterward because he weighed less than 70 kilograms. The patient reported immediate improvement in his symptoms.; Sender's Comments: Based on the information in the case, an association between the reported event myopericarditis and the suspect product bnt162b2 cannot be ruled out.  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.