Rhabdomyolysis and Myocarditis After BNT162b2 Vaccination Require Thorough Investigation

Concerning cardiac compromise, we should know if Takotsubo Cardiomyopathy (TTS) was ruled out as a differential of the cardiological complaints. TTS has been repeatedly reported as a complication of SARS-CoV-2 vaccinations [2]. Arguments for TTS are that the myocardium was hypokinetic, that the ECG showed ST-depression, and that troponin and CK were elevated. TTS mimics myocardial infarction clinically, chemically, electro-physiologically, and on echocardiography but coronary angiography is normal. Rhabdomyolysis has been repeatedly reported as a complication of SARS-CoV-2 vaccinations [3]. However, symptoms started with sensory disturbances [1]. Because the patient complained about sensory disturbances at onset and because Nerve Conduction Studies (NCSs) of the lower extremities revealed reduced amplitude of the sensory Nerve Action Potential (SNAP), sensory polyneuropathy or Small Fiber Neuropathy (SFN) need to be ruled out appropriately. Both sensory polyneuropathy and SFN have been previously reported as complications of SARS-CoV-2 vaccinations [4].