Myocarditis is an inflammatory disease of the muscle layer of the heart, the myocardium, which can clinically manifest itself in different syndromes.

Symptoms may include fatigue, fever, night sweats, joint pain, or weight loss.
Symptoms of acute mycarditis appear after a few hours and last for about seven days. For example, pain in the middle of the chest, which worsens when taking a deep breath, and calms down when sitting; neck and shoulder pain; fever; in the chronic phase, the heart may not be able to pump blood properly, and it may progress to heart failure.

Cases of adolescents and young adults developing myocarditis after vaccination with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccines have been reported worldwide.

https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.122.061025

This is research aimed to investigate the immune profiles of adolescents and young adults who developed myocarditis after receiving the vaccine. Researchers prospectively collected blood samples from 16 patients who were hospitalized with myocarditis after receiving the SARS-CoV-2 vaccine and compared them with 45 healthy, age-matched vaccinated control subjects. They performed extensive antibody profiling, including tests of humoral responses specific to SARS-CoV-2 and assessments of autoantibodies or antibodies against other viruses. They also analyzed T-cell responses and cytokine production in blood samples. They found that the immune responses induced by the mRNA vaccine did not differ between patients who developed myocarditis and control subjects. However, they found that patients with myocarditis had higher levels of free, unbound spike proteins in their blood, which may be a potential cause of myocarditis in these individuals.

The study looked at sixty-one adolescents and young adults between the ages of 12 and 21, including 16 with vaccine-related myocarditis, with blood samples for analysis. Most people with myocarditis were men, and symptoms usually appeared within the first week after vaccination. Most of these people developed myocarditis after the second dose of the vaccine, but some developed it after the first or third booster dose. All patients presented with chest pain and had elevated levels of cardiac troponin T and C-reactive protein. The researchers compared the serological responses of individuals with myocarditis to those of asymptomatic vaccinated control subjects and found no significant differences in levels of anti-spike or anti-RBD immunoglobulin M, IgG, or IgA, or in the ability of antibodies to engage Fc receptors or activate complement. They also found no significant levels of autoantibodies or strong antibody responses to common pathogens in the myocarditis group compared to the control group.

The myocarditis group also had cytokine profiles similar to those seen in a condition called MIS-C (multisystem inflammatory syndrome in children), with elevated levels of interleukin (IL)-8, IL-6, tumor necrosis factor-α, IL- 10, interferon-γ and IL-1β, and lower levels of IL-4 compared to the control group. Additionally, the total number of leukocytes and neutrophils significantly increased in the group with myocarditis, while the number of platelets decreased. These results suggest that post-vaccination myocarditis is associated with normal adaptive and T-cell immunity but modest innate activation.

Another study published:

New Taiwanese study finds high rate of cardiac side effects in high school students after 2nd dose of Pfizer.“4928 (62,1%) were included in the study. The ratio of men to women was 4576/352. A total of 763 students (17.1%) had at least one cardiac symptom after the second dose of the vaccine, mainly chest pain and palpitations. An abnormal ECG was obtained in 51 (1.0%) students, 1 of whom had been diagnosed with mild myocarditis, and for another 4 were assessed as having significant arrhythmia.

Source: https://pubmed.ncbi.nlm.nih.gov/36602621/

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