From the Connecticut Office of the Chief Medical Examiner, Farmington, Connecticut, (Gill).
From the Department of Pathology, Yale School of Medicine, New Haven, Connecticut (Gill).
Arch Pathol Lab Med. 2022 Aug 1;146(8):925-929. doi: 10.5858/arpa.2021-0435-SA.
CONTEXT.—: Myocarditis in adolescents has been diagnosed clinically following the administration of the second dose of an mRNA vaccine for coronavirus disease 2019 (COVID-19).
OBJECTIVE.—: To examine the autopsy microscopic cardiac findings in adolescent deaths that occurred shortly following administration of the second Pfizer-BioNTech COVID-19 dose to determine if the myocarditis described in these instances has the typical histopathology of myocarditis.
DESIGN.—: Clinical and autopsy investigation of 2 teenage boys who died shortly following administration of the second Pfizer-BioNTech COVID-19 dose.
RESULTS.—: The microscopic examination revealed features resembling a catecholamine-induced injury, not typical myocarditis pathology.
CONCLUSIONS.—: The myocardial injury seen in these postvaccine hearts is different from typical myocarditis and has an appearance most closely resembling a catecholamine-mediated stress (toxic) cardiomyopathy. Understanding that these instances are different from typical myocarditis and that cytokine storm has a known feedback loop with catecholamines may help guide screening and therapy.
在接种 2019 年冠状病毒病（COVID-19）mRNA 疫苗的第二剂后，临床上诊断出青少年心肌炎。
检查青少年在接种第二剂辉瑞-生物技术公司 COVID-19 疫苗后不久死亡的尸检心脏微观发现，以确定这些情况下描述的心肌炎是否具有心肌炎的典型组织病理学。
对 2 名在接种第二剂辉瑞-生物技术公司 COVID-19 疫苗后不久死亡的青少年男孩进行临床和尸检调查。
显微镜检查显示出类似于儿茶酚胺诱导损伤的特征，而不是典型的心肌炎病理学。
这些疫苗接种后心脏中所见的心肌损伤与典型心肌炎不同，其外观最类似于儿茶酚胺介导的应激（毒性）心肌病。了解这些情况与典型心肌炎不同，并且细胞因子风暴与儿茶酚胺之间存在已知的反馈回路，这可能有助于指导筛查和治疗。
