Development of Complete Atrioventricular Block Following the Administration of the COVID-19 vaccine in a Young Patient: a Case Report

Abstract Background COVID-19 vaccines have been a crucial element in combating the COVID-19 pandemic. With a substantial portion of the world’s population receiving the vaccine, uncommon side effects, such as abnormalities in the cardiac conduction system, have become apparent. Case Presentation This case report details a 16-year-old female patient who presented with persistent generalized fatigue, excessive sleepiness, and dizziness after receiving her second dose of the Pfizer-BioNTech vaccine. Initially, the patient sought medical attention at an outpatient clinic, where she was diagnosed with pericarditis. The treatment plan included prednisolone, colchicine, and esomeprazole, but the patient did not experience any improvement. One month later, the patient sought medical attention at our hospital and underwent an extensive medical evaluation. Electrocardiogram (ECG) findings were significant for complete atrioventricular (AV) dissociation, confirming the diagnosis of a third-degree heart block. After a thorough discussion regarding all possible interventions with the patient took place, an informed decision was made to implant a permanent pacemaker. Complete resolution of symptoms was reported by the patient at the 3-month follow-up visit. Conclusions The association between COVID-19 vaccines and heart conduction issues has led to various theories, considering factors like hypoxia, electrolyte imbalance, and cytokine responses. While congenital heart block parallels have been explored, transient AV blocks challenge this notion. Cytokine-mediated immune responses are linked to vaccine-induced myocarditis. Recent literature reports myocardial injury following Pfizer-BioNTech and Sino-pharm vaccinations, notably in elderly patients. Management protocols for device implantation during COVID-19 infection remain unclear. In conclusion, despite the novel and vague nature of this case, medical professionals need to be cautious of this possible complication in young and healthy patients after receiving their COVID-19 vaccine shots.