Open AccessBiopsy-Proven Fulminant Myocarditis Requiring Mechanical Circulatory Support Following COVID-19 mRNA Vaccination
Author(s) -
S. Kazama,
Takahiro Okumura,
Yuki Kimura,
Ryota Ito,
Takashi Araki,
Takashi Mizutani,
Hideo Oishi,
Tasuku Kuwayama,
Hiroaki Hiraiwa,
Toru Kondo,
Ryota Morimoto,
Tomoaki Saeki,
Toyoaki Murohara
Publication year - 2022
Publication title -
cjc open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.241
H-Index - 3
ISSN - 2589-790X
DOI - 10.1016/j.cjco.2022.02.004
Subject(s) - medicine , myocarditis , cardiogenic shock , circulatory system , impella , extracorporeal membrane oxygenation , fulminant , cd8 , immunology , immune system , myocardial infarction
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. The 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 investigation is needed before these can be established as pathogenetic mechanisms.
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