Background:
The Covid-19 pandemic has led to development of Covid-19 vaccine. There is an increase in cases of myocarditis and pericarditis after mRNA Covid-19 vaccination. Most cases have a short course of disease however, here we described a case of recurrent pericarditis following the first dose of Pfizer-BioNTech Covid-19 vaccine.
Case:
A 22-year-old male patient presented with typical symptoms of pericarditis and related ECG changes but normal echocardiogram, 12 days post receiving the first dose of Covid-19 vaccine. No other causes were identified from series of investigations. His symptoms responded promptly to oral ibuprofen for 2 weeks and colchicine. 8 weeks later, he redeveloped chest pain and fever, ECG findings identical to the initial presentation and high inflammatory markers. Negative Covid-19 PCR testing. Repeat echocardiogram was normal. Viral serology, Quantiferon and autoimmune screen were negative. No pericardial thickening in CT scan.
Decision-making:
Based on this clinical picture, recurrent pericarditis was diagnosed, and he was hospitalized. Received Aspirin and Colchicine. Steroid avoided as it has a high rate of recurrence. Seven days from admission to the hospital the patient's condition improved and discharged to continue Colchicine for 3 months.
Conclusion:
Patient's case was discussed with a multidisciplinary team and advised the patient not to receive the second dose of the vaccine, due to possible susceptibility to immune-related vaccine reaction.
Footnotes
Poster Contributions
For exact presentation time, refer to the online ACC.22 Program Planner at https://www.abstractsonline.com/pp8/#!/10461
Session Title: Complex Clinical Cases: MD/PhD Flatboard Poster Selections – COVID
Abstract Category: MD/PhD: Coronavirus Disease (COVID-19)