{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:15:21Z","timestamp":1761808521186},"reference-count":13,"publisher":"Oxford University Press (OUP)","issue":"Supplement_C","license":[{"start":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T00:00:00Z","timestamp":1652918400000},"content-version":"vor","delay-in-days":18,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,5,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The rate of post-vaccine myocarditis is being studied from the beginning of the massive vaccination campaign against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although a direct cause\u2013effect relationship has been described, in most cases, the vaccine pathophysiological role is doubtful. Moreover, it is not quite as clear as having had a previous myocarditis could be a risk factor for a post-vaccine disease relapse. A 27-year-old man presented to the emergency department for palpitations and pericardial chest pain radiated to the upper left limb, on the 4th day after the third dose of BNT162b2 vaccine. He experienced a previous myocarditis 3\u2009years before, with full recovery and no other comorbidities. Electrocardiogram showed normal atrioventricular conduction, incomplete right bundle branch block, and diffuse ST-segment elevation. A cardiac echo showed lateral wall hypokinesis with preserved ejection fraction. Troponin-T was elevated (160\u2009ng\/L), chest X-ray was normal, and the SARS-CoV-2 molecular buffer was negative. High-dose anti-inflammatory therapy with ibuprofen and colchicine was started; in the 3rd day high-sensitivity Troponin I reached a peak of 23000\u2009ng\/L. No heart failure or arrhythmias were observed. A cardiac magnetic resonance was performed showing normal biventricular systolic function and abnormal tissue characterization suggestive for acute non-ischaemic myocardial injury (increased native T1 and T2 values, increased signal intensity at T2-weighted images and late gadolinium enhancement, all findings with matched subepicardial distribution) at the level of mid to apical septal, anterior, and anterolateral walls. A left ventricular electroanatomic voltage mapping was negative (both unipolar and bipolar), while the endomyocardial biopsy showed a picture consistent with active myocarditis. The patient was discharged in good clinical condition, on bisoprolol 1.25\u2009mg, ramipril 2.5\u2009mg, ibuprofen 600\u2009mg three times a day, colchicine 0.5\u2009mg twice a day. We presented the case of a young man with history of previous myocarditis, admitted with a non-complicated acute myopericarditis relapse occurred 4\u2009days after SARS-CoV-2 vaccination (3rd dose). Despite the observed very low incidence of cardiac complications following BNT162b2 administration, and the lack of a clear proof of a direct cause\u2013effect relationship, we think that in our patient this link can be more than likely. In the probable need for additional SARS-CoV-2 vaccine doses in the next future, studies addressing the risk-benefit balance of this subset of patient are warranted. We described a multidisciplinary management of a case of myocarditis recurrence after the third dose of SARS-CoV-2 BNT162b2 vaccine.<\/jats:p>","DOI":"10.1093\/eurheartj\/suac018","type":"journal-article","created":{"date-parts":[[2022,5,19]],"date-time":"2022-05-19T06:19:13Z","timestamp":1652941153000},"page":"C243-C247","source":"Crossref","is-referenced-by-count":2,"title":["A case of myopericarditis recurrence after third dose of BNT162b2 vaccine against SARS-CoV-2 in a young subject: link or causality?"],"prefix":"10.1093","volume":"24","author":[{"given":"Massimo","family":"Mapelli","sequence":"first","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via della Commenda 19, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Amelotti","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via della Commenda 19, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Andreini","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"},{"name":"Department of Biomedical and Clinical Sciences \u201cLuigi Sacco\u201d, University of Milan, Via G. B. Grassi 74, 20157 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Baggiano","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via della Commenda 19, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeness","family":"Campodonico","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via della Commenda 19, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Massimo","family":"Moltrasio","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benedetta","family":"Majocchi","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Mantegazza","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlo","family":"Vignati","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Ribatti","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valentina","family":"Catto","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rita","family":"Sicuso","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco","family":"Moltrasio","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Pontone","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piergiuseppe","family":"Agostoni","sequence":"additional","affiliation":[{"name":"Heart Failure Unit, Centro Cardiologico Monzino, IRCCS, Via Parea 4, 20138 Milan, Italy"},{"name":"Department of Clinical Sciences and Community Health, Cardiovascular Section, University of Milan, Via della Commenda 19, 20122 Milan, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,5,18]]},"reference":[{"key":"2022060104144693700_suac018-B1","doi-asserted-by":"crossref","first-page":"977","DOI":"10.15585\/mmwr.mm7027e2","article-title":"Use of mRNA COVID-19 vaccine after reports of myocarditis among vaccine recipients: update from the Advisory Committee on Immunization Practices\u2014United States, June 2021","volume":"70","author":"Gargano","year":"2021","journal-title":"MMWR Morb Mortal Wkly 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