PMC8637777_01
Electrocardiogram on the patient's presentation to emergency room. Noted
sinus tachycardia with, concave ST segment elevation with depressed PR
segment in leads V3 to V6, DI, DII, aVL, and ST segment depression with PR
segment elevation in lead aVR.
10.1177_11795468211056634-fig1.jpg
PMC8637777_01_10.1177_11795468211056634-fig1.jpg
fig1-11795468211056634
Transthoracic echocardiography (parasternal long-axis view) showed cardiac
cavities of normal dimension and slightly thickened ventricular walls (with
an 12 mm ventricular septum). No pericardial effusion was observed.
10.1177_11795468211056634-fig2.jpg
PMC8637777_01_10.1177_11795468211056634-fig2.jpg
fig2-11795468211056634
No pericardial effusion was observed (Figure 2).
Trends in cardiac troponin I levels. The peak level was 14.2 ng/mL. The cut
off value was 0.045 ng/mL.
10.1177_11795468211056634-fig3.jpg
PMC8637777_01_10.1177_11795468211056634-fig3.jpg
fig3-11795468211056634
Serum Troponin I peak level was 14.2 ng/mL (<0.045 ng/mL) with an initial oscillating profile which later decreased (Figure 3).
(A) Four-chamber view of late gadolinium enhancement image, (B) Four-chamber
view of T2-weighted image. The image obtained after administration of
intravenous gadolinium (A) showed multiple nodular foci of late gadolinium
enhancement in subepicardial topography in the mid-distal segments of the
anterolateral wall. These segments were hyperintense on T2-weighted image
(B) which demonstrate the presence of myocardial edema/inflammation.
10.1177_11795468211056634-fig4.jpg
PMC8637777_01_10.1177_11795468211056634-fig4.jpg
fig4-11795468211056634
These results and the medical history suggest the diagnosis of perimyocarditis which was considered to be a consequence of COVID-19 vaccination (Figure 4A and B).