PDF(Pubmed)
Abstract：
Coronavirus disease 2019 (COVID-19) mRNA vaccine-related cases of pericarditis and myocarditis have been reported infrequently. Most of the patients usually present within a week of the vaccine, and on average, most of the cases were reported after the second dose of vaccine within two to four days. Chest pain was the most common presentation, and fever and shortness of breath were the other commonly reported symptoms. The patients can have positive cardiac markers and electrocardiogram (EKG) changes, and the cases can be mistaken for cardiac emergencies. We present a 17-year-old male patient with sudden onset substernal chest pain for two days who got the third dose of the Pfizer-BioNTech mRNA vaccine within 24 hours prior. EKG was remarkable for diffuse ST elevations, and troponins were elevated. Later, the cardiac magnetic resonance imaging confirmed the findings of myopericarditis. The patient was treated with colchicine and non-steroidal anti-inflammatory drugs (NSAIDs), completely recovered, and is doing fine to date. This case hights that post-vaccine myocarditis can be mistaken and early diagnosis and management can prevent unnecessary interventions.
摘要：
2019年冠状病毒病（COVID-19）mRNA疫苗相关的心包炎和心肌炎病例报道很少。大多数患者通常在疫苗接种后一周内出现，平均而言,大多数病例是在第二剂疫苗接种后两到四天内报告的。胸痛是最常见的表现，发烧和呼吸急促是其他常见的症状。患者可以有阳性的心脏标志物和心电图（EKG）变化，这些病例可能被误认为是心脏急症.我们介绍了一名17岁的男性患者，患有两天的突然发作的胸骨后胸痛，他在24小时前服用了第三剂Pfizer-BioNTechmRNA疫苗。心电图表现为弥漫性ST段抬高,肌钙蛋白升高。稍后，心脏磁共振成像证实了心肌心包炎的发现。患者接受秋水仙碱和非甾体抗炎药（NSAIDs）治疗，完全恢复,到目前为止做得很好。这种情况表明疫苗后心肌炎可能是错误的，早期诊断和管理可以防止不必要的干预。
