Short axis (A) and four-chamber long axis (B) post-contrast inversion recovery images showed subepicardial late gadolinium enhancement in the anterolateral wall of the mid and apical left ventricle. Cine images showed normal left ventricular function. ) was performed on a 3-T scanner six days after the second dose of vaccine. The patient was referred for cardiac magnetic resonance imaging (MRI) to evaluate for myocarditis. Troponin levels continued to rise, peaking at 20.4 ng/mL on hospital day 2 and declined to 9.5 ng/mL by the time of discharge on the morning of hospital day 3, at which point his chest pain had resolved. An echocardiogram showed normal function and no significant valvular disease ejection fraction was 55%. The patient was admitted and underwent coronary angiography that showed normal coronary arteries. Nasopharyngeal SARS-CoV-2 PCR was performed twice and was negative the patient also denies any history of infection with COVID-19. Initial laboratory evaluation showed an elevated troponin I of 14 ng/mL (normal <0.032 ng/mL), an elevated C-reactive protein (CRP) of 25 ng/mL (normal 0–0.5 ng/mL), and erythrocyte sedimentation rate (ESR) of 25 mm/h (normal <15 mm/h). An electrocardiogram (ECG) revealed diffuse mild concave ST elevations with no reciprocal changes. His physical examination revealed a fever of 39.1 ☌, blood pressure of 129/75 mmHg, pulse of 76 bpm, a respiratory rate of 20, and oxygen saturation of 98% on room air. Six hours after the onset of fevers, the patient noticed substernal chest pain and as result reported to the hospital. On the first day after the second dose the patient developed subjective fever and chills. A previously healthy 25-year-old man presents to the hospital after receiving the second dose of the mRNA-1273 SARS-CoV-2 immunization (Moderna).
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