Munjal Jaskaran S, Flores Sergio M, Yousuf Hamza, Gupta Vasu, Munjal Ripudaman S, Anamika Fnu, Mendpara Vaidehi, Shah Priyanshi, Jain Rohit
Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India.
University of Monterrey, Mexico.
J Community Hosp Intern Med Perspect. 2023 Sep 2;13(5):44-49. doi: 10.55729/2000-9666.1229. eCollection 2023.
Myocarditis and pericarditis are rare adverse reactions, more commonly seen in young males after receiving the second dose of an mRNA vaccine. However, the benefits of vaccination heavily outweigh the risk of these side effects. In addition, vaccination boosters are effective against the newest, more infective variants. Therefore we expect more vaccines to be administered in the following years. The objective of this study is to review the current understanding of the mechanism, diagnosis, and treatment of myocarditis and pericarditis. Proposed mechanisms include molecular mimicry against the S protein and hypersensitivity reactions with mRNA vaccines and platelet aggregation and thrombus formation in cardiac blood vessels with adenoviral vaccines. Diagnosis of myocarditis is based on clinical findings, cardiac enzymes, ECG, MRI, and echocardiographic findings. Management includes NSAIDs and cardiovascular support in selected cases with ventricular dysfunction. Most patients have a mild presentation with preservation of cardiac function and recover entirely within seven days; the average hospital stay is three days. Long-term complications are infrequent.
心肌炎和心包炎是罕见的不良反应，在年轻男性接种第二剂mRNA疫苗后更为常见。然而，接种疫苗的益处远远超过这些副作用的风险。此外，加强接种疫苗对最新、传染性更强的变异毒株有效。因此，我们预计在未来几年会有更多疫苗接种。本研究的目的是综述目前对心肌炎和心包炎的发病机制、诊断及治疗的认识。提出的机制包括针对S蛋白的分子模拟以及mRNA疫苗引发的超敏反应，还有腺病毒疫苗导致的心脏血管内血小板聚集和血栓形成。心肌炎的诊断基于临床表现、心肌酶、心电图、磁共振成像和超声心动图检查结果。治疗包括在部分出现心室功能障碍的病例中使用非甾体抗炎药并给予心血管支持。大多数患者表现轻微，心脏功能得以保留，且在七天内完全康复；平均住院时间为三天。长期并发症并不常见。
