Fazlollahi et al.: "Cardiac complications following mRNA COVID-19 vaccines: A systematic review of case reports and case series"; the plot thickens

by Paul Alexander

Sixty-nine studies, including 43 case reports & 26 case series, were included; a review of only case reports & case series is a limitation of this examination yet the findings are potent & informative




‘Myocarditis/myopericarditis and pericarditis were the most common adverse events among the 243 reported cardiac complications, post mRNA COVID-19 vaccination.

Males with a median age of 21 years had the highest frequency of myocarditis.

Almost three quarters (74.4%) of cases with myocarditis had received the BNT162b2 (Pfizer) vaccine and 87.7% had received the second dose of the vaccine.

Chest pain (96.1%) and fever (38.2%) were the most common presentations. CK-MB, troponin, and NT-proBNP were elevated in 100%, 99.5% and 78.3% of subjects, respectively.

ST-segment abnormality was the most common electrocardiogram feature.

Cardiac magnetic resonance imaging, which is the gold-standard approach for diagnosing myocarditis, was abnormal in all patients diagnosed with myocarditis.

Non-steroidal anti-inflammatory drugs were the most prescribed medication for the management of myocarditis.

Apart from inflammatory conditions, some rare cases of Takotsubo cardiomyopathy, myocardial infarction, myocardial infarction with non-obstructive coronary arteries, and isolated tachycardia were also reported following immunization with mRNA COVID-19 vaccines.

Myocarditis was the most commonly reported adverse cardiac event associated with mRNA COVID-19 vaccines, which presented as chest pain with a rise in cardiac biomarkers. Further large-scale observational studies are recommended.’