关键词: COVID-19 mRNA Cardiac magnetic resonance imaging Myocarditis

来  源:   DOI:10.1016/j.radcr.2023.11.070   PDF(Pubmed)

Abstract:
We present a case involving a young individual who developed acute myocarditis on the fourth day following administration of a COVID-19 mRNA vaccine. The patient\'s condition was managed conservatively, resulting in a favorable outcome. This paper extensively discusses the pathogenesis, clinical manifestations, imaging characteristics of COVID-19 mRNA vaccine-related myocarditis and includes a comprehensive review of pertinent literature. Additionally, a systematic review of COVID-19 mRNA vaccine-related myocarditis, conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) principles, is presented. Healthcare professionals should maintain a clinical suspicion for COVID-19 mRNA vaccine-related myocarditis when encountering patients with confirmed myocarditis who have received recent COVID-19 mRNA vaccination, after ruling out other potential causes. The diagnosis of acute myocarditis primarily relies on adherence to the Lake Louise Criteria (LLC) for cardiac magnetic resonance (CMR). Nevertheless, specific CMR features or distinctive patterns indicative of COVID-19 mRNA vaccine-related myocarditis are currently undefined. Among patients with vaccine-related myocarditis, common CMR findings encompass subepicardial late gadolinium enhancement and T2-based myocardial edema, although these findings lack specificity and may resemble other medical conditions. Supportive care involving a short-term regimen of NSAIDs, colchicine, and steroids represents the cornerstone of treatment for this variant of myocarditis, which tends to be self-limiting with favorable short-term prognoses. Timely diagnosis is paramount for optimizing patient care.
摘要:
我们介绍了一例涉及一名年轻个体的病例,该个体在服用COVID-19mRNA疫苗后的第四天发展为急性心肌炎。病人的病情得到了保守的管理,导致有利的结果。本文广泛讨论了发病机制,临床表现,COVID-19mRNA疫苗相关性心肌炎的影像学特征,包括对相关文献的全面回顾。此外,COVID-19mRNA疫苗相关性心肌炎的系统评价,根据系统评价和荟萃分析(PRISMA)原则的首选报告项目进行,是presented。当遇到最近接受过COVID-19mRNA疫苗接种的确诊心肌炎患者时,医疗保健专业人员应保持对COVID-19mRNA疫苗相关心肌炎的临床怀疑,在排除其他潜在原因后。急性心肌炎的诊断主要取决于坚持LakeLouise标准(LLC)的心脏磁共振(CMR)。然而,COVID-19mRNA疫苗相关性心肌炎的具体CMR特征或独特模式目前尚不明确。在疫苗相关性心肌炎患者中,常见的CMR发现包括心外膜下钆晚期增强和基于T2的心肌水肿,尽管这些发现缺乏特异性,并且可能与其他医学疾病相似。涉及NSAIDs短期治疗方案的支持性护理,秋水仙碱,类固醇是治疗这种心肌炎的基石,这往往是自我限制的,短期预后良好。及时诊断对于优化患者护理至关重要。
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