tetano
Editor, Senior Moderator
CJC Open
. 2022 Feb 13.
doi: 10.1016/j.cjco.2022.02.004. Online ahead of print.
Biopsy-proven Fulminant Myocarditis Requiring Mechanical Circulatory Support Following COVID-19 mRNA Vaccination
Shingo Kazama[SUP] 1 [/SUP], Takahiro Okumura[SUP] 1 [/SUP], Yuki Kimura[SUP] 1 [/SUP], Ryota Ito[SUP] 1 [/SUP], Takashi Araki[SUP] 1 [/SUP], Takashi Mizutani[SUP] 1 [/SUP], Hideo Oishi[SUP] 1 [/SUP], Tasuku Kuwayama[SUP] 1 [/SUP], Hiroaki Hiraiwa[SUP] 1 [/SUP], Toru Kondo[SUP] 1 [/SUP], Ryota Morimoto[SUP] 1 [/SUP], Tomoaki Saeki[SUP] 2 [/SUP], Toyoaki Murohara[SUP] 1 [/SUP]
Affiliations
Abstract
A 48-year-old woman suffered from cardiogenic shock with fulminant myocarditis following the second dose of COVID-19 vaccine (mRNA-1273). Venoarterial extracorporeal membrane oxygenation and Impella® support were essential in achieving hemodynamic stability. Endomyocardial biopsy revealed lymphocytic infiltration with predominant immunostaining for CD8 and CD68 positive cells. Left ventricular ejection fraction improved significantly after treatment with mechanical circulatory support. Myocarditis following COVID-19 mRNA vaccination may also occur in middle-aged women; it may be fulminant and require mechanical circulatory support. Although our results suggest the involvement of cytotoxic T lymphocytes and macrophages, further investigations are needed before establishing this pathogenetic mechanisms.
Keywords: COVID-19; COVID-19, coronavirus disease 2019; EMB, endomyocardial biopsy; LVEF, left ventricular ejection fraction; VA-ECMO, venoarterial extracorporeal membrane oxygenation; cardiogenic shock; endomyocardial biopsy; myocarditis; vaccination.
. 2022 Feb 13.
doi: 10.1016/j.cjco.2022.02.004. Online ahead of print.
Biopsy-proven Fulminant Myocarditis Requiring Mechanical Circulatory Support Following COVID-19 mRNA Vaccination
Shingo Kazama[SUP] 1 [/SUP], Takahiro Okumura[SUP] 1 [/SUP], Yuki Kimura[SUP] 1 [/SUP], Ryota Ito[SUP] 1 [/SUP], Takashi Araki[SUP] 1 [/SUP], Takashi Mizutani[SUP] 1 [/SUP], Hideo Oishi[SUP] 1 [/SUP], Tasuku Kuwayama[SUP] 1 [/SUP], Hiroaki Hiraiwa[SUP] 1 [/SUP], Toru Kondo[SUP] 1 [/SUP], Ryota Morimoto[SUP] 1 [/SUP], Tomoaki Saeki[SUP] 2 [/SUP], Toyoaki Murohara[SUP] 1 [/SUP]
Affiliations
- PMID: 35187464
- PMCID: PMC8842092
- DOI: 10.1016/j.cjco.2022.02.004
Abstract
A 48-year-old woman suffered from cardiogenic shock with fulminant myocarditis following the second dose of COVID-19 vaccine (mRNA-1273). Venoarterial extracorporeal membrane oxygenation and Impella® support were essential in achieving hemodynamic stability. Endomyocardial biopsy revealed lymphocytic infiltration with predominant immunostaining for CD8 and CD68 positive cells. Left ventricular ejection fraction improved significantly after treatment with mechanical circulatory support. Myocarditis following COVID-19 mRNA vaccination may also occur in middle-aged women; it may be fulminant and require mechanical circulatory support. Although our results suggest the involvement of cytotoxic T lymphocytes and macrophages, further investigations are needed before establishing this pathogenetic mechanisms.
Keywords: COVID-19; COVID-19, coronavirus disease 2019; EMB, endomyocardial biopsy; LVEF, left ventricular ejection fraction; VA-ECMO, venoarterial extracorporeal membrane oxygenation; cardiogenic shock; endomyocardial biopsy; myocarditis; vaccination.