STEMI PRESENTATIONS IN YOUNG MALES AFTER MRNA VACCINE

Background:

Vaccination efforts worldwide continue in the face of the ongoing pandemic of COVID-19. More than 6.65 billion doses of the COVID-19 vaccine have been administered thus far. Adverse events after receiving the vaccine are being reported and monitored closely. Recently, there have been increasing reports of myocarditis/pericarditis in young men after receiving a second dose of the mRNA vaccine. Rare complications such as vaccine-induced immune thrombotic thrombocytopenia and thrombotic thrombocytopenic syndrome have been identified after the administration of viral vector vaccines. We present here three STEMI cases in young, healthy males three days after receiving the second dose of an mRNA vaccine.

Methods:

Three males aged 19-34 years old with no past medical history presented to the emergency department with ST elevations on EKG and increased troponin I. They were each taken to the cardiac catheterization lab. All patients had received a second dose of mRNA vaccine within four days prior to presentation.

Results:

All three patients had no evidence of coronary obstruction on cardiac catheterization. They were admitted overnight, and their troponin I levels trended downwards without further intervention.

Conclusion:

With the relatively new advent of mRNA vaccines against the COVID-19 virus, there are still many potential short and long-term complications that have yet to be identified. The patient presentations herein were suspicious for acute coronary syndrome given their typical anginal chest pain, acute troponin I rise and fall, and EKG changes indicative of myocardial ischemia. However, there was no evidence of obstruction on left heart catheterization in any of these cases. Given these findings, it is possible that cardiac inflammation or coronary vasospasm are correlated with having received a second dose of the mRNA vaccine. Further studies are needed to determine if these occurrences are merely coincidental or if they can be directly attributed to such vaccines. Going forward, it is imperative to obtain COVID-19 vaccination history whenever a patient presents to a healthcare setting, as we continue to learn about the possible and varied sequelae of such vaccines.