Boudihi Abdelaziz, El-Azrak Mohammed, Doudouh Othmane, Ismaili Nabila, El Ouafi Noha
Department of Cardiology, Mohammed VI University Hospital of Oujda, First Mohammed University of Oujda, Morocco.
Faculty of medicine and pharmacy Oujda, University Mohammed I, Morocco.
Radiol Case Rep. 2022 Nov 23;18(2):435-440. doi: 10.1016/j.radcr.2022.09.053. eCollection 2023 Feb.
We report the case of a 23 years old patient who developed an acute myocardial infarction one day after his second dose of COVID-19 BIBP vaccination, complicated by severe left ventricle systolic dysfunction with an ejection fraction measured at 32%, associated with left ventricular wall motion abnormalities well evolved under treatment of heart failure with reduced EF combining :angiotensin-converting enzyme inhibitor, beta blocker, mineralocorticoid receptor antagonists and sodium-glucose cotransporter 2 inhibitors. Coronary arteries were normal at angiography suggesting initially the diagnostic of myocarditis. Therefore, a cardiac magnetic resonance imaging was performed to confirm the latter, which showed an image consistent with a recent left ventricular subendocardial infarction, remarkably prominent in the left anterior descending artery territory and the absence of signs of myocarditis. The patient had no previous past medical history or other clinical features explaining this coronary event onset. Thus, the vaccine was potentially to be implicated in the pathophysiology of the event. Overall, complications associated with COVID-19 vaccines are extremely rare, and their benefit is well established. That's why they continue to be recommended by public health experts despite of their rare side effects.
我们报告了一例23岁患者的病例,该患者在第二次接种新冠病毒灭活疫苗一天后发生急性心肌梗死,并发严重左心室收缩功能障碍,射血分数为32%,伴有左心室壁运动异常,在射血分数降低的心力衰竭治疗中病情好转,治疗方案包括联合使用血管紧张素转换酶抑制剂、β受体阻滞剂、盐皮质激素受体拮抗剂和钠-葡萄糖协同转运蛋白2抑制剂。血管造影显示冠状动脉正常,最初提示诊断为心肌炎。因此,进行了心脏磁共振成像以确诊,结果显示图像与近期左心室心内膜下梗死相符,在左前降支动脉区域尤为明显,且无心肌炎迹象。该患者既往无病史或其他临床特征可解释此次冠状动脉事件的发生。因此,疫苗可能与该事件的病理生理机制有关。总体而言,与新冠病毒疫苗相关的并发症极为罕见,其益处已得到充分证实。这就是尽管存在罕见的副作用,公共卫生专家仍继续推荐接种疫苗的原因。