Heart complication seen for the first time in a young patient after COVID-19 vaccination

Cases of Takotsubo cardiomyopathy (TCM) have increased during the COVID-19 pandemic, and a new case study in Circulation: Cardiovascular Imaging examined what is believed to be the first case of reverse Takotsubo cardiomyopathy (rTCM) in a young, vaccinated woman. 

Citing a case study published in JAMA Network Open by Jabri et al., the study's authors noted that TCM cases increased during the pandemic by 78%, a change that helped contribute "to an increased intensive medical care." 

The group shared the case of a 30-year-old Asian women who presented in an emergency department with chest pain. She had received the second mRNA COVID-19 vaccine two days prior and reported "general fatigue."

Coronary computed tomography angiography (CCTA) showed no significant stenosis in epicardial coronary arteries or aortic dissection, the authors wrote. CCTA did show signs of akinesis at the basal portion of the left ventricle as visualized using transthoracic doppler echo-cardiography.

“These findings supported our diagnosis of rTCM,” wrote lead author Hiroki Yamaura, MD, with the department of cardiovascular medicine at Fujiikai Kashibaseiki Hospital in Japan, and colleagues. 

Yamaura et al. noted that while the efficacy and safety of COVID-19 vaccines have been established, severe side effects related to the cardiovascular system have been rarely reported.

“Although the majority of myocarditis induced by COVID-19 vaccination seems like to follow a minor course of illness, the  prevalence  and  clinical  course  of TCM  following  COVID-19 vaccinations remain largely unknown,” the authors wrote. “This is the first reported case of rTCM following COVID-19 vaccination in a young woman. While transthoracic Dopple echocardography, coronary angiography, and cardiac magnetic resonance are the gold-standard diagnostic tools for TCM, CCTA may be useful as an alternative diagnostic tool for TCM for the differentiation of acute coronary syndrome and myocardial  infarction with nonobstructive coronary arteries, especially in young women during the COVID-19 pandemic."

Read the full case study here.

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