Frontiers in Cardiovascular Medicine (Apr 2022)

Case Report: Importance of MRI Examination in the Diagnosis and Evaluation of COVID-19 mRNA Vaccination Induced Myocarditis: Our Experience and Literature Review

  • Keita Watanabe,
  • Keita Watanabe,
  • Takashi Ashikaga,
  • Yasuhiro Maejima,
  • Susumu Tao,
  • Mao Terui,
  • Tetsuya Kishigami,
  • Masakazu Kaneko,
  • Ryota Nakajima,
  • Shinichiro Okata,
  • Tetsumin Lee,
  • Tomoki Horie,
  • Masashi Nagase,
  • Giichi Nitta,
  • Ryoichi Miyazaki,
  • Sho Nagamine,
  • Yasutoshi Nagata,
  • Toshihiro Nozato,
  • Masahiko Goya,
  • Tetsuo Sasano

DOI
https://doi.org/10.3389/fcvm.2022.844626
Journal volume & issue
Vol. 9

Abstract

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Acute myocarditis is a rare but serious complication associated with mRNA-based coronavirus disease 2019 (COVID-19) vaccination. In this article, four COVID-19 mRNA vaccination induced myocarditis cases managed at our tertiary Medical Center have been discussed. Three patients had typical myocarditis. One patient suffered from atrioventricular block and heart failure, which required more intensive treatment, but eventually improved. Additionally, a review of cardiac magnetic resonance imaging (MRI) features related to the diagnosis of myocarditis showed that COVID-19 mRNA vaccine-associated myocarditis tend to have more late-gadolinium enhancement (LGE) accumulation in the inferior lateral wall direction. According to a report by the U.S. Centers for Disease Control and Prevention (CDC), the diagnosis of COVID-19 mRNA vaccine-associated myocarditis is based on clinical symptoms, altered myocardial enzymes, cardiac MRI finding, or histopathology. Cardiac MRI is relatively less invasive than myocardial biopsy and plays an important role in the diagnosis of myocarditis. This review may aid in the diagnosis of COVID-19 mRNA vaccine-associated myocarditis.

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