Emergency Department, Ibn Sina Hospital, Faculty of Medicine and Pharmacy in Rabat, Rabat, Morocco.
Pan Afr Med J. 2023 Apr 20;44:192. doi: 10.11604/pamj.2023.44.192.35425. eCollection 2023.
COVID-19 vaccines have reduced both lethality and hospitalization rates of the novel coronavirus disease. Nevertheless, multiple side effects have been reported in the literature, most often are harmless. We report two cases of acute myocarditis, hospitalized in the emergency department for chest pain occurring after the second dose of mRNA vaccine AstraZeneca. The SARS-Cov-2 infection was ruled out in both patients with a negative PCR obtained by nasal swabs and normal thoracic CT scans. Both patients had high levels of high-sensitive cardiac troponin I. Acute coronary syndromes were excluded with cardiac catheterization. Cardiac Magnetic resonance imaging (MRI) showed signs in favor of acute myocarditis. The evolution was favorable for both patients after being put on anti-inflammatory treatment. The universality and accumulation of reports concerning acute myocarditis following COVID vaccination, in the absence of any other diagnostic element that could explain the myocardial injury, establish a strong causal link, although the etiopathogenesis of such injury remains poorly elucidated.
COVID-19 疫苗降低了新型冠状病毒病的致死率和住院率。然而，文献中已经报道了多种副作用，大多数情况下是无害的。我们报告了两例急性心肌炎病例，这两例患者因第二剂阿斯利康 mRNA 疫苗接种后出现胸痛而住进急诊科。通过鼻拭子获得的阴性 PCR 和正常的胸部 CT 扫描排除了这两名患者的 SARS-Cov-2 感染。两名患者的高敏心肌肌钙蛋白 I 水平均升高。通过心导管检查排除了急性冠状动脉综合征。心脏磁共振成像（MRI）显示支持急性心肌炎的迹象。在接受抗炎治疗后，两名患者的病情均好转。在没有任何其他可以解释心肌损伤的诊断因素的情况下，COVID 疫苗接种后急性心肌炎的报告普遍性和积累性，建立了一个强有力的因果关系，尽管这种损伤的病因学仍不清楚。
