Key result
COVID-19 mRNA vaccine-associated myocarditis primarily shows LGE on the epicardial or sub-epicardial free wall.
Why the study?
Acute myocarditis is a rare but serious complication associated with mRNA-based COVID-19 vaccination, and cardiac MRI plays an important, less invasive role in its diagnosis.
Does cardiac MRI identify specific patterns of late gadolinium enhancement in patients with COVID-19 mRNA vaccine-associated myocarditis?
Case Report (n=62)
No
Does cardiac MRI identify specific patterns of late gadolinium enhancement in patients with COVID-19 mRNA vaccine-associated myocarditis?
Cardiac MRI is a valuable non-invasive tool for diagnosing COVID-19 mRNA vaccine-associated myocarditis, which typically presents with epicardial or sub-epicardial late gadolinium enhancement predominantly in the inferolateral wall.
Cardiac MRI may identify a predominant epicardial LGE pattern in mRNA vaccine myocarditis; leaves open diagnostic specificity and need for prospective validation.
Acute myocarditis is a rare but serious complication associated with mRNA-based coronavirus disease 2019 (COVID-19) vaccination. In this article, four COVID-19 mRNA vaccination induced myocarditis cases managed at our tertiary Medical Center have been discussed. Three patients had typical myocarditis. One patient suffered from atrioventricular block and heart failure, which required more intensive treatment, but eventually improved. Additionally, a review of cardiac magnetic resonance imaging (MRI) features related to the diagnosis of myocarditis showed that COVID-19 mRNA vaccine-associated myocarditis tend to have more late-gadolinium enhancement (LGE) accumulation in the inferior lateral wall direction. According to a report by the U.S. Centers for Disease Control and Prevention (CDC), the diagnosis of COVID-19 mRNA vaccine-associated myocarditis is based on clinical symptoms, altered myocardial enzymes, cardiac MRI finding, or histopathology. Cardiac MRI is relatively less invasive than myocardial biopsy and plays an important role in the diagnosis of myocarditis. This review may aid in the diagnosis of COVID-19 mRNA vaccine-associated myocarditis.
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Watanabe et al. (2022) conducted a case report in COVID-19 mRNA vaccination-induced myocarditis (n=62). COVID-19 mRNA vaccine was evaluated on Localization of late-gadolinium enhancement (LGE) on cardiac MRI. In patients with COVID-19 mRNA vaccine-associated myocarditis, late-gadolinium enhancement on cardiac MRI occurred most frequently on the epicardial or sub-epicardial free wall side.
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