"Introduction: ... In our case report, we describe a remarkable case of COVID-19 vaccination-induced cardiomyopathy with such a profound and permanent left ventricular dysfunction that required durable left ventricular assist device (LVAD) placement ...
The mechanism behind the development of myocarditis is not well understood; however, it is believed to be secondary to molecular mimicry between the spike protein of COVID-19 and the self-antigen that triggers a dysregulation and cascade of immune pathways in response to the mRNA. The presentation of cardiomyopathy after the second vaccine dose suggests that prior exposure to the vaccine was relevant to the hypersensitivity response. In our case, the patient had COVID-19 infection first and was later vaccinated. We postulate that cardiomyopathy was likely a result of the inflammatory process associated with SARS-CoV-2 infection and the subsequent cytokine storm from the vaccination. We also theorize that such a response of the immune system might be elicited in COVID-19-infected patients after vaccination, and it may be the cause of severe myocardial injury requiring mechanical support or heart transplant."
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