Key result
A 51-year-old woman developed late-onset myocarditis presenting with non-sustained ventricular tachycardia and sub-epicardial fibrosis on cardiac MRI following ChAdOx1 vaccination.
Case Report (n=1)
This case highlights the rare possibility of late-onset, subclinical myocarditis presenting with ventricular arrhythmias and subepicardial scarring following ChAdOx1 COVID-19 vaccination.
Should not alter vaccination practices; hypothesis-generating for late ChAdOx1-related myocardial scars in arrhythmia patients.
A 51-year-old woman who had received 2 injections of a ChAdOx1 vaccine in 2021 and a booster dose in 2022 was recently admitted for central chest pain accompanied with palpitations for the previous 2 weeks. She was negative for the COVID-19 virus, troponin was not elevated, both the 12-lead electrocardiogram and 2D echocardiogram were normal. At peak exercise during exercise treadmill test she developed a single ventricular couplet, but coronary angiography revealed normal coronary arteries. A 24-hour electrocardiogram recording revealed symptomatic non-sustained ventricular tachycardia while she was in bed. A 3T cardiac magnetic resonance imaging (MRI) demonstrated late gadolinium sub-epicardial uptake at the left ventricle apex suggesting fibrosis. The patient was diagnosed as late presentation of myocarditis following ChAdOx1 vaccination, and was discharged on oral amiodarone and colchicine.
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Natarajan et al. (2023) conducted a case report in Myocarditis (n=1). ChAdOx1 vaccine was evaluated on Development of myocarditis and ventricular arrhythmia. A 51-year-old woman developed late-onset myocarditis presenting with non-sustained ventricular tachycardia and sub-epicardial fibrosis on cardiac MRI following ChAdOx1 vaccination.
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