• Hiroaki Kawano, Tetsufumi Motokawa, Hirokazu Kurohama, Shinji Okano, Ryohei Akashi, Tsuyoshi Yonekura, Satoshi Ikeda, Koichi Izumikawa, and Koji Maemura.
• Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Japan.
• Intern. Med. 2022 Aug 1; 61 (15): 2319-2325.

AbstractA 60-year-old Japanese woman was hospitalized for cardiogenic shock 24 days after receiving the second dose of the coronavirus disease 2019 BNT162b2 vaccine. Impella CP left ventricular assist device implantation and venoarterial peripheral extracorporeal membranous oxygenation were immediately initiated along with inotropic support and steroid pulse therapy, as an endomyocardial biopsy specimen showed myocarditis. Three weeks later, her cardiac function had recovered, and she was discharged. An immune response associated with the presence of spike protein in cardiac myocytes may be related to myocarditis in the present case because of positive immunostaining for severe acute respiratory syndrome coronavirus 2 spike protein and C4d in the myocardium.

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