Index Entries

James R. Gill, Randy Tashjian, and Emily Duncanson
February 14, 2022
Archives of Pathology & Laboratory Medicine

Context: Myocarditis in adolescents has been diagnosed clinically following the administration of the second dose of an mRNA vaccine for coronavirus disease 2019 (COVID-19).

Objective: To examine the autopsy microscopic cardiac findings in adolescent deaths that occurred shortly following administration of the second Pfizer-BioNTech COVID-19 dose to determine if the myocarditis described in these instances has the typical histopathology of myocarditis.

Results: The microscopic examination revealed features resembling a catecholamine-induced injury, not typical myocarditis pathology.

Conclusions: The myocardial injury seen in these postvaccine hearts is different from typical myocarditis and has an appearance most closely resembling a catecholamine-mediated stress (toxic) cardiomyopathy.

Discussion: … Toxic myocarditis is an etiologic classification involving direct myocardial injury by various drugs or substances. Although variable, the histologic features consist of 2 main patterns: an early stage with foci of solely necrotic/damaged myocytes and the later phase of ‘myocarditis.’ Toxic myocarditis usually indicates inflammatory stages of catecholamine-induced myocardial injury.”

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adverse events,COVID-19,heart disorders,mRNA,vaccines