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Myocarditis Following COVID-19 Vaccination is a Condition That Affects Very Few
Heart Inflammation is Rare but Affects Young Men Ages 12 to 39
By Nancy Kennedy

Recent media stories have reported concerns about an increasing number of cases of myocarditis, an inflammatory heart condition, following COVID-19 vaccination, but the condition is extremely rare and affects only a very small and specific segment of the population. For the great majority of Americans, it is not a risk at all.

Myocarditis (inflammation of the heart muscle) and pericarditis (inflammation of the lining around the outside of the heart) are rare complications of COVID-19 vaccination, and occur primarily in young adults and adolescent males, ages 12 to 39. Fortunately, the condition is self-limiting, readily treatable and unlikely to progress to chronic or long term cardiac problems, says Alan Bramowitz, M.D., a board-certified cardiologist with Jefferson Cardiology Association who cares for patients with all types of cardiovascular disease.

"A study conducted at Baylor University and reported last summer in the American Heart Association journal Circulation revealed that myocarditis has been found to occur in a small group of young men, mostly after the second dose of the vaccine," Dr. Bramowitz explains. "It occurs within a few days to a week after vaccination. The symptoms of myocarditis are chest pain, shortness of breath and fatigue, but in general the patients do not become very ill; young men are likely to be in good health to begin with. Myocarditis can be diagnosed with an examination, echocardiogram and/or cardiac MRI, cardiac troponin levels and other bloodwork. It is treated with NSAIDS (non-steroidal anti-inflammatory drugs) and rest. The patients improve quickly - symptoms resolve and the diagnostic markers and imaging studies return to normal. Patients who are recovering can usually resume their physical activities with guidance from their PCP."

According to the Centers for Disease Control (CDC), the rate of occurrence of myocarditis/pericarditis is 12.6 cases per million doses of second-dose mRNA vaccine. Myocarditis was less commonly seen after the third vaccination.

The reason for the condition's incidence among young males exclusively is unknown at the present time but the CDC is monitoring and reviewing cases. Post-vaccination myocarditis is considered an "adverse event" - a rare complication of vaccination - and is therefore required to be reported to the CDC's Vaccine Adverse Event Reporting System (VAERS). Vaccination for other diseases, including smallpox, flu, and hepatitis B can also cause myocarditis, although this is also rare.

As a potentially lethal virus that may have long term complications for many organ systems, COVID-19 is a far greater risk than vaccination, Dr. Bramowitz says. "No one should forego receiving the COVID vaccination because of concerns about myocarditis."

Myocarditis can occur as part of the body's inflammatory response to COVID infection. When the body is exposed to an infection like COVID-19, an inflammatory response is triggered, and this response can sometimes be exaggerated, leading to stress or damage to organs such as the heart and lungs.

Pericarditis, which affects the sac that surrounds the heart, can restrict the heart's ability to expand and contract. It is painful with inspiration, and deep breathing makes the chest pain worsen. Positioning matters: the chest pain is worse with lying down, and improves when the patient sits up.

For more information, visit www.jeffersoncardiology.com or call (412) 469-1500.

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