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CDC investigating 200+ cases of heart inflammation after COVID-19 vaccine

The CDC has scheduled an "emergency meeting" to review data related to myocarditis, an inflammation of the heart muscle, in a relatively small group of young people.

CHARLOTTE, N.C. — The Center for Disease Control will hold an emergency meeting on June 18 to discuss rare cases of myocarditis, an inflammation of the heart, reported in roughly 225 patients after they received the COVID-19 vaccine, NBC News reported Thursday.

How many cases of myocarditis have been reported after COVID-19 vaccines?

The cases, which total 226 people, or about 0.00015% of the 141 million fully vaccinated American adults, have occurred mainly in younger people below the age of 30 after they received their second dose of an mRNA vaccine, which would include either the Moderna or Pfizer shot, according to data from the CDC and NBC News.

Since April 2021, there have been increased reports to the Vaccine Adverse Event Reporting System (VAERS) of cases of inflammation of the heart happening after mRNA COVID-19 vaccination (Pfizer-BioNTech and Moderna) in the United States. 

It was still too early to determine whether those cases were caused by the vaccine or another factor.

Many things can cause heart inflammation. Common causes include viral or bacterial infections, such as the coronavirus itself, as well as medical conditions that damage the heart and cause inflammation.

What are the symptoms of heart inflammation?

There are three main types of heart inflammation: endocarditis, myocarditis, and pericarditis. 

Endocarditis is inflammation of the inner lining of the heart’s chambers and valves. Myocarditis is inflammation of the heart muscle. Pericarditis is inflammation of the tissue that forms a sac around the heart. 

You may have different signs and symptoms depending on the type and severity of the heart inflammation that you have.

The 226 patients who reported having heart inflammation after the COVID-19 vaccine were diagnosed with Myocarditis.

Endocarditis

  • Fever and chills
  • New or worsening heart murmur
  • Blood in urine
  • Spleen that is larger than normal
  • Abdominal pain
  • Chest pain
  • Cough, with or without the presence of blood
  • Loss of appetite and weight loss
  • Muscle, joint, and back pain
  • Night sweats
  • Pain where an infected cardiac device is located
  • Shortness of breath
  • Skin changes, which can occur with endocarditis. These may be painful red or purple bumps, or painless flat red spots on places such as the palms of your hands or soles of your feet, or tiny reddish purple spots from broken blood vessels.

Myocarditis

  • Chest pain and discomfort
  • Heart palpitations
  • Fainting
  • Shortness of breath
  • Fatigue
  • Abdominal pain
  • Exercise intolerance, or no longer being able to exercise
  • Fever
  • Loss of appetite
  • Swelling of feet or legs
  • Weakness

Pericarditis

  • Chest pain. Chest pain from pericarditis typically feels sharp, gets worse with breathing, and feels better with sitting up and leaning forward.
  • Fast heartbeat
  • Fever
  • Shortness of breath

Treat for heart inflammation

Your doctor may prescribe one or more medicines to treat heart inflammation, depending on the type and cause of heart inflammation.

Mild cases of myocarditis and pericarditis may go away without treatment.

Endocarditis

  • Antibiotics to treat bacterial infections. Side effects of antibiotics depend on which antibiotic is used but may include diarrhea; problems with hearing, balance, and kidneys; and decreased white blood cell counts. Some of these side effects may not happen until treatment is finished.
  • Antifungal medicines to treat fungal infections. Sometimes your doctor may recommend lifelong oral antifungal treatment to prevent the infection from returning. Possible side effects of antifungal medicines include allergic reactions, such as diarrhea, dizziness, itching, blisters or hives, difficulty breathing, weight loss, and jaundice.
  • Blood thinners to treat some types of endocarditis

Myocarditis

  • Corticosteroids to lower the activity of the body’s immune system. Corticosteroids may be used to treat myocarditis caused by autoimmune diseases, such as lupus.
  • Heart failure medicines to decrease the work of the heart when heart failure is a complication. Your doctor may recommend medicines such as beta blockers and angiotensin-converting enzyme (ACE) inhibitors.
  • Intravenous immunoglobulin (IVIG) helps control the body’s immune and inflammatory response.

Pericarditis

  • Anti-inflammatory medicines to treat pericarditis. These include colchicine, aspirin, and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and indomethacin. Side effects are mainly gastrointestinal and include abdominal pain, nausea, vomiting, and diarrhea.
  • Corticosteroids to lower the activity of the body’s immune system. With pericarditis, corticosteroids are used only in patients who are not responding to or cannot take NSAIDs.
  • Intravenous immunoglobulin (IVIG) to help control the body’s immune and inflammatory response. This may be used when there is an autoimmune disorder, such as lupus.

If left untreated, complications can include serious arrhythmias, blood clots, or heart failure.

A doctor's advise

Dr. Jerome Williams, Jr., a practicing cardiologist with Novant Health, said, right now, there is no concrete proof the shot is the cause of the condition, noting that viruses can also cause it, including the virus that causes COVID-19.

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"The report suggests the rates of myocarditis in young adults have not differed from expected baseline rates," Williams said.

Williams said someone with viral myocarditis would typically be put on rest, and the heart usually heals on its own.

"The symptoms are often mild fatigue, sometimes shortness of breath, sometimes chest pain, but sometimes individuals can have heart failure and arrhythmias," Williams said.

He does not think parents or young adults getting the vaccine should be alarmed, but they should know the signs and also know the benefits of the shot are high.

"If it's truly a rare side effect from the vaccine, it pales in comparison to the potential risk of COVID-19, including the persistent syndrome called long-COVID, which we see in adults and young adults as well," Williams said.

Since the emergency use authorization of Pfizer for adolescents, statewide providers have administered shots to more than 78,000 12 to 17-year-olds, according to North Carolina Department of Health and Human Services data. 

Over the last three weeks, that group's share of vaccinations has soared to between one-quarter to one-third of all new shots.

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