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Acute cardiac events following ChAdOx1 nCoV-19 corona virus vaccine: report of three cases


 Acute myocarditis following COVID-19 vaccination has been observed majorly following mRNA vaccines. Recently a single case of ChAdOx1 nCoV-19 vaccination induced myocarditis with an ischemic presentation has been reported. Here we report three cases of acute cardiac events following ChAdOx1 nCoV-19 vaccination, in an elderly female, a middle-aged male and a middle-aged female. The first case presented with an ischemic phenotype, the second with acute heart failure, and the third with cardiac symptoms and magnetic resonance imaging evidence of myocardial inflammation. The patients were all managed successfully with conservative treatment and showed symptomatic improvement within few weeks which was further corroborated by improved electrocardiographic and echocardiographic findings in the first two patients. The possibilities of molecular mimicry, autoimmunity and direct S-protein induced toxicity to the heart may need to be evaluated in the future to explain cardiac adverse events of COVID-19 vaccines.