{
    "abstract": "A 71-year-old man was transferred urgently to our hospital after collapsing near his home post the first shot of the BNT162b2 coronavirus disease 2019 vaccine (Pfizer-BioNTech, Comirnaty\u00ae). Immediately after arrival at our hospital, cardiac arrest due to complete atrioventricular block with no ventricular escaped beats was observed on electrocardiogram. Echocardiography showed preserved left ventricular ejection fraction, however, diffuse severe hypokinesia was revealed after 3\u202fweeks, and he died 3\u202fmonths after admission because of worsening heart failure. An autopsy examination revealed eosinophilic myocarditis or hypersensitivity myocarditis with extensive fibrosis and widespread myocardial dropout throughout the heart.\n1. Severe myocarditis occurs extremely rarely after mRNA coronavirus disease 2019 (COVID-19) vaccination. 2. Myocarditis after mRNA COVID-19 vaccination might cause complete atrioventricular block, followed by a course of decreased left ventricular ejection fraction. 3. Histologically, severe myocarditis after mRNA COVID-19 vaccination seems to present as fulminant necrotizing eosinophilic myocarditis or hypersensitivity myocarditis.",
    "authors": [
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Naoaki",
            "initials": "N",
            "lastname": "Onishi"
        },
        {
            "affiliation": "Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Yuki",
            "initials": "Y",
            "lastname": "Konishi"
        },
        {
            "affiliation": "Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Toshiyuki",
            "initials": "T",
            "lastname": "Kaneko"
        },
        {
            "affiliation": "Japanese Red Cross Otsu Hospital, Otsu, Japan.\nJapanese Red Cross Wakayama Medical Center, Wakayama, Japan.",
            "firstname": "Naohiro",
            "initials": "N",
            "lastname": "Maekawa"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Akihira",
            "initials": "A",
            "lastname": "Suenaga"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.\nJapanese Red Cross Wakayama Medical Center, Wakayama, Japan.",
            "firstname": "Shinnosuke",
            "initials": "S",
            "lastname": "Nomura"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Takayasu",
            "initials": "T",
            "lastname": "Kobayashi"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Shokan",
            "initials": "S",
            "lastname": "Kyo"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Marie",
            "initials": "M",
            "lastname": "Okabayashi"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Hirooki",
            "initials": "H",
            "lastname": "Higami"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Maki",
            "initials": "M",
            "lastname": "Oi"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Nobuya",
            "initials": "N",
            "lastname": "Higashitani"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Sayaka",
            "initials": "S",
            "lastname": "Saijo"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Fumiko",
            "initials": "F",
            "lastname": "Nakazeki"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Naofumi",
            "initials": "N",
            "lastname": "Oyamada"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Toshikazu",
            "initials": "T",
            "lastname": "Jinnai"
        },
        {
            "affiliation": "Division of Pathology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Tomoko",
            "initials": "T",
            "lastname": "Okuno"
        },
        {
            "affiliation": "Division of Pathology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Tomoyuki",
            "initials": "T",
            "lastname": "Shirase"
        },
        {
            "affiliation": "Division of Cardiology, Japanese Red Cross Otsu Hospital, Otsu, Japan.",
            "firstname": "Kazuaki",
            "initials": "K",
            "lastname": "Kaitani"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 2023 Japanese College of Cardiology. Published by Elsevier Ltd.",
    "doi": "10.1016/j.jccase.2023.01.004",
    "journal": "Journal of cardiology cases",
    "keywords": [
        "BNT162b2",
        "Complete atrioventricular block",
        "Coronavirus disease 2019",
        "Eosinophilic myocarditis",
        "Hypersensitivity myocarditis",
        "mRNA"
    ],
    "methods": null,
    "publication_date": "2023-02-14",
    "pubmed_id": "36779079\n33683637\n35076665\n32904735\n34667594\n34978002\n35157759\n29096807\n34856634\n28912184\n34738500",
    "results": null,
    "title": "Fulminant myocarditis with complete atrioventricular block after mRNA COVID-19 vaccination: A case report.",
    "xml": "<Element 'PubmedArticle' at 0x788507084e00>"
}