Cardiac magnetic resonance imaging of myocarditis and pericarditis following COVID-19 vaccination: a multicenter collection of 27 cases

TY - JOUR

T1 - Cardiac magnetic resonance imaging of myocarditis and pericarditis following COVID-19 vaccination

T2 - a multicenter collection of 27 cases

AU - Di Dedda, Emanuele Angelo

AU - Barison, Andrea

AU - Aquaro, Giovanni Donato

AU - Ismail, Tevfik F.

AU - Hua, Alina

AU - Mantini, Cesare

AU - Ricci, Fabrizio

AU - Pontone, Gianluca

AU - Volpe, Alessandra

AU - Secchi, Francesco

AU - Di Renzi, Paolo

AU - Lovato, Luigi

AU - Niro, Fabio

AU - Liguori, Carlo

AU - De Biase, Chiara

AU - Monti, Lorenzo

AU - Cirò, Antonio

AU - Marano, Riccardo

AU - Natale, Luigi

AU - Moliterno, Eleonora

AU - Esposito, Antonio

AU - Vignale, Davide

AU - Faletti, Riccardo

AU - Gatti, Marco

AU - Porcu, Michele

AU - Saba, Luca

AU - Chimenti, Cristina

AU - Galea, Nicola

AU - Francone, Marco

N1 - Publisher Copyright: © 2022, The Author(s), under exclusive licence to European Society of Radiology.

PY - 2022/7/1

Y1 - 2022/7/1

N2 - 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.

AB - 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.

KW - COVID-19

KW - Magnetic resonance imaging

KW - Myocarditis

KW - Pericarditis

KW - Vaccination

UR - http://www.scopus.com/inward/record.url?scp=85125368869&partnerID=8YFLogxK

U2 - 10.1007/s00330-022-08566-0

DO - 10.1007/s00330-022-08566-0

M3 - Article

C2 - 35230520

AN - SCOPUS:85125368869

SN - 0938-7994

VL - 32

SP - 4352

EP - 4360

JO - European Radiology

JF - European Radiology

IS - 7

ER -