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接种肺炎球菌疫苗后发生疫苗相关性心肌炎，导致急性二尖瓣反流。

A case of vaccine-associated myocarditis following pneumococcal immunization leading to acute mitral regurgitation.

机构信息

Department of Cardiovascular Medicine, Narita Tomisato Tokushukai Hospital, 1-1-1 Hiyoshidai, Tomisato, Chiba, 286-0201, Japan.

Department of Cardiology, Chiba-Nishi General Hospital, Matsudo, Japan.

出版信息

ESC Heart Fail. 2022 Jun;9(3):2013-2019. doi: 10.1002/ehf2.13881. Epub 2022 Mar 14.

DOI:10.1002/ehf2.13881
PMID:35289507
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9065829/
Abstract

Vaccine-associated myocarditis (VAM) is a rare entity but can result in potentially serious sequelae if left untreated. However, the mechanisms of the complications of VAM and its treatment remain unclear. Herein, we report the first case of VAM related to pneumococcal immunization, presenting as a local and systemic inflammatory reaction, in which the patient developed significant secondary mitral regurgitation, resulting in acute heart failure. Finally, the patient recovered completely following corticosteroid treatment. This case highlights the value of cardiac magnetic resonance and the pitfall of endomyocardial biopsy in establishing the definitive diagnosis of VAM and emphasizes the importance of optimal management in understanding the mechanism and instituting the treatment for secondary mitral regurgitation caused by VAM.

摘要

疫苗相关心肌炎（VAM）较为罕见，但如果不及时治疗，可能会导致严重的后果。然而，VAM 的并发症及其治疗机制仍不清楚。在此，我们报告首例与肺炎球菌免疫接种相关的 VAM 病例，表现为局部和全身炎症反应，患者出现严重的二尖瓣反流，导致急性心力衰竭。最终，患者接受皮质类固醇治疗后完全康复。该病例强调了心脏磁共振的价值和心肌活检在明确诊断 VAM 中的陷阱，并强调了优化管理的重要性，以了解 VAM 导致的二尖瓣反流的机制并进行治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/9065829/2b81b6bc7fbe/EHF2-9-2013-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/9065829/85ad9ae61977/EHF2-9-2013-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/9065829/de4e9f9743b9/EHF2-9-2013-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/9065829/2b81b6bc7fbe/EHF2-9-2013-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/9065829/85ad9ae61977/EHF2-9-2013-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/9065829/de4e9f9743b9/EHF2-9-2013-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5372/9065829/2b81b6bc7fbe/EHF2-9-2013-g002.jpg

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