{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T21:22:18Z","timestamp":1783113738360,"version":"3.54.6"},"reference-count":22,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,2,20]],"date-time":"2024-02-20T00:00:00Z","timestamp":1708387200000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2024,2,1]],"date-time":"2024-02-01T00:00:00Z","timestamp":1706745600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2024,2]]},"abstract":"<jats:sec>\n                    <jats:title>Key Clinical Message<\/jats:title>\n                    <jats:p>This case underscores the importance of considering myocardial infarction with nonobstructive coronary arteries (MINOCA) in patients experiencing acute chest pain following rabies vaccination, emphasizing the need for heightened awareness and further research into the association between MINOCA and Rabies vaccination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Abstract<\/jats:title>\n                    <jats:p>Rabies is a vaccine\u2010preventable deadly viral disease prevalent in Asia and Africa that causes thousands of deaths annually. Rabies pre (PrEP) and postexposure prophylaxis (PEP) is highly effective in annulling rabies\u2010associated deaths. The adverse reactions following rabies vaccination are typically mild. Myocardial infarction with non\u2010obstructive coronary arteries (MINOCA) is a rare condition, and its association with rabies vaccination is unprecedented. We present a case of a 43\u2010year\u2010old male with MINOCA following Rabies PEP. A 43\u2010year\u2010old male, nonsmoker and nonalcoholic, presented to the ER with complaints of acute onset left sided chest pain following the completion of the third dose of intradermal rabies vaccine, whose clinical features, ECG changes and lab reports were suggestive of acute presentation of inferior wall MI. Coronary angiography was performed, which however revealed normal coronaries with only slow flow being noted in the left anterior descending (LAD) artery. Echocardiography later showed a normal study with no other relevant diagnosis unveiled on further investigations. Hence a diagnosis of vaccine\u2010induced MINOCA was made. Treatment included antiplatelet therapy, statins, and beta\u2010blockers. MINOCA following rabies vaccination is an unprecedented finding. The clear etiology behind this couldn't be ascertained. The patient's treatment was conventional, emphasizing the need for further research and clinical trials in MINOCA diagnosis and management. This case highlights the need for clinicians to consider MINOCA in patients with acute chest pain post\u2010rabies vaccination. Further research is essential to unravel the association between MINOCA and rabies vaccination, paving the way for optimal management strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccr3.8532","type":"journal-article","created":{"date-parts":[[2024,2,21]],"date-time":"2024-02-21T00:15:36Z","timestamp":1708474536000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Myocardial infarction with\n                    <scp>nonobstructive<\/scp>\n                    coronaries (\n                    <scp>MINOCA<\/scp>\n                    ) following rabies\n                    <scp>postexposure<\/scp>\n                    prophylaxis: A case report"],"prefix":"10.1002","volume":"12","author":[{"given":"Reechashree","family":"Dhungana","sequence":"first","affiliation":[{"name":"Department of Cardiology Manmohan Cardiothoracic Vascular and Transplant Center Institute of Medicine Maharajgunj Medical Campus  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-2077-9831","authenticated-orcid":false,"given":"Prajjwal","family":"Pokharel","sequence":"additional","affiliation":[{"name":"Department of Cardiology Manmohan Cardiothoracic Vascular and Transplant Center  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chandra Mani","family":"Poudel","sequence":"additional","affiliation":[{"name":"Department of Cardiology Manmohan Cardiothoracic Vascular and Transplant Center  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raja Ram","family":"Khanal","sequence":"additional","affiliation":[{"name":"Department of Cardiology Manmohan Cardiothoracic Vascular and Transplant Center  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Smriti","family":"Shakya","sequence":"additional","affiliation":[{"name":"Department of Cardiology Manmohan Cardiothoracic Vascular and Transplant Center  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratna Mani","family":"Gajurel","sequence":"additional","affiliation":[{"name":"Department of Cardiology Manmohan Cardiothoracic Vascular and Transplant Center  Kathmandu Nepal"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,2,20]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"Rabies"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.2147\/VMRR.S51147"},{"key":"e_1_2_10_4_1","volume-title":"National Guideline for Rabies Prophylaxis in Nepal","year":"2019"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.55489\/njcm.130720221516"},{"key":"e_1_2_10_6_1","unstructured":"Adverse Reaction|Specific Groups|CDC.Centers for Disease Control and Prevention National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) Division of High\u2010Consequence Pathogens and Pathology (DHCPP). Accessed November 13 2023.https:\/\/www.cdc.gov\/rabies\/specific_groups\/hcp\/adverse_reaction.html"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/HEARTJNL-2020-318269"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(23)03154-6"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1136\/BMJOPEN-2022-066587"},{"key":"e_1_2_10_10_1","volume-title":"Information Sheet Observed Rate of Vaccine Reactions Rabies Vaccine","year":"2012"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1159\/000509100"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/EURHEARTJ\/EHW149"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/FCVM.2022.742010\/FULL"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.6314\/JIMT.201906_30(3).01"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.3978\/J.ISSN.2223-3652.2011.10.01"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.EJIM.2022.11.026"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.AMJMED.2019.05.048"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.IJCARD.2019.09.037"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000670"},{"key":"e_1_2_10_20_1","volume-title":"Rabies Prevention in Nepal\u2014CIWEC Clinic","year":"2023"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/J.TMAID.2020.101868"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1586\/14760584.2015.973403"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/2048872618782414"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8532","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.8532","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.8532","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T20:59:11Z","timestamp":1783112351000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.8532"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2]]},"references-count":22,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2024,2]]}},"alternative-id":["10.1002\/ccr3.8532"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.8532","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2]]},"assertion":[{"value":"2023-11-13","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-01-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-02-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e8532"}}