![]() ![]() The patient was then started on standard treatment with Ibuprofen 800 mg Q6H and pantoprazole for gastric protection. Mild patchy delayed subepicardial enhancement was also noted in the mid cavity and basal posterolateral wall (suggestive of post-inflammatory scarring related to localized myocarditis.) During this time, CK-MB and Troponin-I continued to trend upwards. ![]() The imaging revealed acute myopericarditis with a small pericardial effusion. Cardiology was consulted and following a normal echocardiogram, the patient was sent for a stat cardiac MRI. Laboratory work revealed elevated troponin-I at 3.18 ng/mL, elevated Total CK at 399 units/L, CK-MB at 19 ng/mL, and BNP <10 pg/mL. Initial evaluation included a normal chest X-ray and normal sinus rhythm on EKG. ![]() He had no history of recent viral illness and no known COVID-19 exposure. Motrin and Tums did not seem to provide any relief. He denied feelings of dizziness, syncope, palpitations, change in pain with position or deep breaths. The patient felt unwell afterwards with myalgias, headache, numbness, tingling, emesis, and 1-day history of fever of 38.8☌. Case Description: A previously well 15-year-old obese male presented to a pediatric ER with 3 days of left arm pain and 1 day of acute left-sided chest pain three days after receiving his second Pfizer-BioNTech COVID-19 vaccine in his left anterior deltoid area. As more of the healthy adolescent male population began receiving the COVID-19 vaccination, cases of myocarditis shortly after became more frequently seen. Introduction: During the pediatric trials for Coronavirus disease 2019 (COVID-19) vaccine the patient population was limited, likely leading to an inappreciable amount of adverse events. ![]()
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