tetano
Editor, Senior Moderator
Eur Radiol
. 2022 Mar 1.
doi: 10.1007/s00330-022-08566-0. Online ahead of print.
Cardiac magnetic resonance imaging of myocarditis and pericarditis following COVID-19 vaccination: a multicenter collection of 27 cases
Emanuele Angelo Di Dedda[SUP] 1 2 [/SUP], Andrea Barison[SUP] 3 [/SUP], Giovanni Donato Aquaro[SUP] 3 [/SUP], Tevfik F Ismail[SUP] 4 [/SUP], Alina Hua[SUP] 4 [/SUP], Cesare Mantini[SUP] 5 [/SUP], Fabrizio Ricci[SUP] 5 [/SUP], Gianluca Pontone[SUP] 6 [/SUP], Alessandra Volpe[SUP] 7 8 [/SUP], Francesco Secchi[SUP] 9 10 [/SUP], Paolo Di Renzi[SUP] 11 [/SUP], Luigi Lovato[SUP] 12 [/SUP], Fabio Niro[SUP] 12 [/SUP], Carlo Liguori[SUP] 13 [/SUP], Chiara De Biase[SUP] 14 [/SUP], Lorenzo Monti[SUP] 2 [/SUP], Antonio Cirò[SUP] 15 [/SUP], Riccardo Marano[SUP] 16 17 [/SUP], Luigi Natale[SUP] 16 17 [/SUP], Eleonora Moliterno[SUP] 17 [/SUP], Antonio Esposito[SUP] 18 19 [/SUP], Davide Vignale[SUP] 18 19 [/SUP], Riccardo Faletti[SUP] 20 [/SUP], Marco Gatti[SUP] 20 [/SUP], Michele Porcu[SUP] 21 [/SUP], Luca Saba[SUP] 21 [/SUP], Cristina Chimenti[SUP] 22 [/SUP], Nicola Galea[SUP] 23 [/SUP], Marco Francone[SUP] 24 25 [/SUP]
Affiliations
Abstract
Objectives: To assess clinical and cardiac magnetic resonance (CMR) imaging features of patients with peri-myocarditis following Coronavirus Disease 2019 (COVID-19) vaccination.
Methods: We retrospectively collected a case series of 27 patients who underwent CMR in the clinical suspect of heart inflammation following COVID-19 vaccination, from 16 large tertiary centers. Our patient's cohort was relatively young (36.6 ± 16.8 years), predominately included males (n = 25/27) with few comorbidities and covered a catchment area of approximately 8 million vaccinated patients.
Results: CMR revealed typical mid-subepicardial non-ischemic late gadolinium enhancement (LGE) in 23 cases and matched positively with CMR T2 criteria of myocarditis. In 7 cases, typical hallmarks of acute pericarditis were present. Short-term follow-up (median = 20 days) from presentation was uneventful for 25/27 patients and unavailable in two cases.
Conclusions: While establishing a causal relationship between peri-myocardial inflammation and vaccine administration can be challenging, our clinical experience suggests that CMR should be performed for diagnosis confirmation and to drive clinical decision-making and follow-up.
Key points: • Acute onset of dyspnea, palpitations, or acute and persisting chest pain after COVID-19 vaccination should raise the suspicion of possible myocarditis or pericarditis, and patients should seek immediate medical attention and treatment to help recovery and avoid complications. • In case of elevated troponin levels and/or relevant ECG changes, cardiac magnetic resonance should be considered as the best non-invasive diagnostic option to confirm the diagnosis of myocarditis or pericarditis and to drive clinical decision-making and follow-up.
Keywords: COVID-19; Magnetic resonance imaging; Myocarditis; Pericarditis; Vaccination.
. 2022 Mar 1.
doi: 10.1007/s00330-022-08566-0. Online ahead of print.
Cardiac magnetic resonance imaging of myocarditis and pericarditis following COVID-19 vaccination: a multicenter collection of 27 cases
Emanuele Angelo Di Dedda[SUP] 1 2 [/SUP], Andrea Barison[SUP] 3 [/SUP], Giovanni Donato Aquaro[SUP] 3 [/SUP], Tevfik F Ismail[SUP] 4 [/SUP], Alina Hua[SUP] 4 [/SUP], Cesare Mantini[SUP] 5 [/SUP], Fabrizio Ricci[SUP] 5 [/SUP], Gianluca Pontone[SUP] 6 [/SUP], Alessandra Volpe[SUP] 7 8 [/SUP], Francesco Secchi[SUP] 9 10 [/SUP], Paolo Di Renzi[SUP] 11 [/SUP], Luigi Lovato[SUP] 12 [/SUP], Fabio Niro[SUP] 12 [/SUP], Carlo Liguori[SUP] 13 [/SUP], Chiara De Biase[SUP] 14 [/SUP], Lorenzo Monti[SUP] 2 [/SUP], Antonio Cirò[SUP] 15 [/SUP], Riccardo Marano[SUP] 16 17 [/SUP], Luigi Natale[SUP] 16 17 [/SUP], Eleonora Moliterno[SUP] 17 [/SUP], Antonio Esposito[SUP] 18 19 [/SUP], Davide Vignale[SUP] 18 19 [/SUP], Riccardo Faletti[SUP] 20 [/SUP], Marco Gatti[SUP] 20 [/SUP], Michele Porcu[SUP] 21 [/SUP], Luca Saba[SUP] 21 [/SUP], Cristina Chimenti[SUP] 22 [/SUP], Nicola Galea[SUP] 23 [/SUP], Marco Francone[SUP] 24 25 [/SUP]
Affiliations
- PMID: 35230520
- DOI: 10.1007/s00330-022-08566-0
Abstract
Objectives: To assess clinical and cardiac magnetic resonance (CMR) imaging features of patients with peri-myocarditis following Coronavirus Disease 2019 (COVID-19) vaccination.
Methods: We retrospectively collected a case series of 27 patients who underwent CMR in the clinical suspect of heart inflammation following COVID-19 vaccination, from 16 large tertiary centers. Our patient's cohort was relatively young (36.6 ± 16.8 years), predominately included males (n = 25/27) with few comorbidities and covered a catchment area of approximately 8 million vaccinated patients.
Results: CMR revealed typical mid-subepicardial non-ischemic late gadolinium enhancement (LGE) in 23 cases and matched positively with CMR T2 criteria of myocarditis. In 7 cases, typical hallmarks of acute pericarditis were present. Short-term follow-up (median = 20 days) from presentation was uneventful for 25/27 patients and unavailable in two cases.
Conclusions: While establishing a causal relationship between peri-myocardial inflammation and vaccine administration can be challenging, our clinical experience suggests that CMR should be performed for diagnosis confirmation and to drive clinical decision-making and follow-up.
Key points: • Acute onset of dyspnea, palpitations, or acute and persisting chest pain after COVID-19 vaccination should raise the suspicion of possible myocarditis or pericarditis, and patients should seek immediate medical attention and treatment to help recovery and avoid complications. • In case of elevated troponin levels and/or relevant ECG changes, cardiac magnetic resonance should be considered as the best non-invasive diagnostic option to confirm the diagnosis of myocarditis or pericarditis and to drive clinical decision-making and follow-up.
Keywords: COVID-19; Magnetic resonance imaging; Myocarditis; Pericarditis; Vaccination.