Role of cardiac MRI to assess myocarditis after vaccination against COVID-19 in adolescents

According to ARRS ‘ American Journal of Radiology (AJR), radiologists should be aware of the link between coronavirus disease mRNA vaccination (COVID-19) and myocarditis, as well as the role of cardiac MRI in assessing suspected myocarditis after vaccination.

“In this small series of cases, all patients with myocarditis after vaccination against COVID-19 were adolescents and had a favorable initial clinical course,” explained first author Lydia Chelala of the Medical University of Chicago. Noting that the cardiac MRI examination of each patient showed findings typical of myocarditis for other reasons, “the late increase in gadolinium (LGE) continued in two patients undergoing repeated MRI.”

The retrospective study of Chelala and team included patients who underwent cardiac MRI between 14 May 2021 and 14 June 2021 for suspected myocarditis within 2 weeks after vaccination with COVID-19 mRNA – without known previous COVID-19. With recorded clinical presentation, hospital course, and post-discharge events, cardiac MRI scans were reviewed by consensus by a cardiothoracic radiologist and a cardiothoracic imaging associate.

Of the 52 patients who underwent cardiac MRI during the study period, Chelala and colleagues identified 5 male patients (age range 16–19 years; mean age 17.2 years) who presented within 4 days after the second dose of COVID-19 mRNA vaccine. After a mean hospital stay of 4.8 days, all 5 patients were discharged in stable condition with improved or resolved symptoms. However, two patients underwent repeated cardiac MRI, which showed persistent, albeit reduced, LGE.

Recognizing that their article is the first report to describe additional short-term follow-up results in this patient population, the authors of this AJR the article also acknowledges that “observations do not establish a causal link”.


American X-ray Society

Reference in the magazine:

Chelala, L., et al. (2021) Cardiac magnetic resonance imaging results in myocarditis after mRNA vaccination against COVID-19 in adolescents. American Journal of Radiology.

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