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We report a case of a 36-year-old active duty service member presenting with progressive dyspnoea, substernal chest pain and lower extremity swelling 5\u2009weeks after receiving the vaccinia vaccination. The aetiology of his acute decompensated heart failure was determined to be from myocarditis. Although the majority of cases of myocarditis resolve completely, some patients develop chronic heart failure and even death. Vaccine-associated myocarditis should always be on the differential for patients that exhibit cardiopulmonary symptoms after recent vaccinations.<\/jats:p>","DOI":"10.1136\/bcr-2017-223523","type":"journal-article","created":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T02:05:19Z","timestamp":1521770719000},"page":"bcr-2017-223523","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":23,"title":["Myocarditis secondary to smallpox vaccination"],"prefix":"10.1136","volume":"2018","author":[{"given":"Kyle","family":"Keinath","sequence":"first","affiliation":[{"name":"Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tyler","family":"Church","sequence":"additional","affiliation":[{"name":"Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Benjamin","family":"Kurth","sequence":"additional","affiliation":[{"name":"Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edward","family":"Hulten","sequence":"additional","affiliation":[{"name":"Cardiology, Walter Reed National Military Medical Center, Bethesda, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,3,22]]},"reference":[{"key":"2025082703510543000_2018.mar21_1.bcr-2017-223523.1","unstructured":"Centers for Disease Control and Prevention. 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