新型冠状病毒肺炎（COVID-19）mRNA疫苗接种后暴发性心肌炎伴完全性房室传导阻滞：一例报告
Fulminant myocarditis with complete atrioventricular block after mRNA COVID-19 vaccination: A case report.
作者信息
Onishi Naoaki, Konishi Yuki, Kaneko Toshiyuki, Maekawa Naohiro, Suenaga Akihira, Nomura Shinnosuke, Kobayashi Takayasu, Kyo Shokan, Okabayashi Marie, Higami Hirooki, Oi Maki, Higashitani Nobuya, Saijo Sayaka, Nakazeki Fumiko, Oyamada Naofumi, Jinnai Toshikazu, Okuno Tomoko, Shirase Tomoyuki, Kaitani Kazuaki
机构信息
Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.
Japanese Red Cross Otsu Hospital, Otsu, Japan.
出版信息
J Cardiol Cases. 2023 May;27(5):229-232. doi: 10.1016/j.jccase.2023.01.004. Epub 2023 Jan 27.
UNLABELLED
A 71-year-old man was transferred urgently to our hospital after collapsing near his home post the first shot of the BNT162b2 coronavirus disease 2019 vaccine (Pfizer-BioNTech, Comirnaty®). Immediately after arrival at our hospital, cardiac arrest due to complete atrioventricular block with no ventricular escaped beats was observed on electrocardiogram. Echocardiography showed preserved left ventricular ejection fraction, however, diffuse severe hypokinesia was revealed after 3 weeks, and he died 3 months after admission because of worsening heart failure. An autopsy examination revealed eosinophilic myocarditis or hypersensitivity myocarditis with extensive fibrosis and widespread myocardial dropout throughout the heart.
LEARNING OBJECTIVE
- Severe myocarditis occurs extremely rarely after mRNA coronavirus disease 2019 (COVID-19) vaccination. 2. Myocarditis after mRNA COVID-19 vaccination might cause complete atrioventricular block, followed by a course of decreased left ventricular ejection fraction. 3. Histologically, severe myocarditis after mRNA COVID-19 vaccination seems to present as fulminant necrotizing eosinophilic myocarditis or hypersensitivity myocarditis.
未标注
一名71岁男性在接种第一剂BNT162b2 2019冠状病毒病疫苗（辉瑞-生物科技公司，Comirnaty®）后在家附近晕倒，随后被紧急转送至我院。抵达我院后立即进行心电图检查，发现因完全性房室传导阻滞且无室性逸搏心律导致心脏骤停。超声心动图显示左心室射血分数正常，然而，3周后出现弥漫性严重心肌运动减弱，入院3个月后因心力衰竭加重死亡。尸检显示为嗜酸性心肌炎或过敏性心肌炎，伴有广泛纤维化和全心脏广泛心肌缺失。
学习目标
- mRNA 2019冠状病毒病（COVID-19）疫苗接种后严重心肌炎极为罕见。2. mRNA COVID-19疫苗接种后心肌炎可能导致完全性房室传导阻滞，随后出现左心室射血分数下降。3. 组织学上，mRNA COVID-19疫苗接种后严重心肌炎似乎表现为暴发性坏死性嗜酸性心肌炎或过敏性心肌炎。
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