164 CASES of myocarditis and 157 cases of pericarditis, in Europe, after the use of m-RNA vaccines for Covid-19, then Pfizer and Moderna. In comparison, it must be said, of just under 200 million doses administered. On the basis of these figures, the European Medicines Agency, through the Safety Committee (Prac) has come to the conclusion that after vaccination with messenger RNA vaccines, very rare cases of these heart conditions can be observed, recommending the inclusion of the inflammation of the myocardium (heart muscle tissue) and pericardium (the membrane covering the heart) among the new side effects linked to the administration of the vaccine.
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According to the team of experts, cases of inflammation occurred within two weeks of vaccination, more frequently after the second dose and in young males. There have also been cases of deaths (5) in people of advanced age or with other pathologies. Among the practical indications, the Committee recommends that experts pay attention to the symptoms potentially linked to these conditions.
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How pericarditis and myocarditis occur
The inflammation of the membrane that protects the heart, in some cases, can give extremely worrying signs and symptoms, in some cases even simulating what occurs in the case of a heart attack. In case of pericarditis in fact, the heart may not work properly because it is as if it were crushed in a vice that does not allow the muscle to expand. Thus, pain can appear, changes in heart rhythm with increased beats, a feeling of malaise.
Few examinations are then sufficient to clarify the picture, which in its exudative form is almost always treated successfully. The problem is understanding the source of the problem. If it is suspected that pericarditis is linked to some specific disease (such as rheumatoid arthritis or lupus) it must be identified and treated, in this way the inflammation of the pericardium will also be resolved.
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However, when a viral infection is involved, treatment must be symptomatic. In all cases, pericarditis of a viral nature manifests itself in the exudative form that forces the heart to be surrounded by the fluid that is created between the outer membrane and its wall.
The constrictive form appears much rarer and can be linked to specific conditions, such as a tuberculous-type infection or can be among the consequences of an operation on the heart. The cardiologist specialist, on a case by case basis, can study the most suitable treatment which in any case depends on the causes that caused the picture: if a viral infection is at stake, it is above all necessary to counteract the symptoms by reducing inflammation and pain. In general, for this purpose, anti-inflammatories and colchicine are administered to promote the reabsorption of excess pericardial fluid.
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The myocarditis it is instead linked to the acute inflammation of the myocardial cells, which is precisely the heart muscle tissue. It manifests itself with symptoms ranging from palpitations with increased heart rate to chest tightness, but in some cases there are fever and unexplained cough. It must be said that also for this picture the viral cause is often important, so much so that, in the period prior to Covid-19, myocarditis was often the consequence of a flu infection.
This inflammation can induce even real arrhythmias in the most serious forms and even lead to the onset of heart failure. The treatment, case by case, must obviously be set by the cardiologist.
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The benefit of immunization remains
Second Alfredo Marchese, president of the Gise Foundation (Italian Society of Interventional Cardiology) and head of the Interventional Cardiology Laboratory at the Santa Maria di Bari Hospital, also in Italy it happens to see pictures of this type. “These conditions can manifest themselves with fever, pain, sometimes even a feeling of breathlessness. But these are precisely linked to an excess of inflammatory response following the vaccine stimulus, much simpler to treat and with a ‘benign’ prognosis compared to reactions induced by the actual viral infection. In short: after vaccination myocarditis, which in general terms can also go completely unnoticed, have a different nature than those, much more serious, which are linked to viral infections with high viral load able to ‘nest’ in the heart muscle “. Generally the course is benign, given that after vaccination with M-Rna vaccines an immune-mediated reaction could be established which is expressed in the myocardium in reaction to vaccination administration.
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“It should be remembered that these pictures are linked to a particularly” lively “response from the young person’s immune system – says Marchese – on the contrary, Covid-19 myocarditis can be very serious, given that it is part of a framework that also involves various organs. and that above all sees the virus continue to replicate incessantly. On the one hand, after vaccination, we can observe an inflammation that can be easily controlled and often is not even perceived, on the other with the natural infection by Sars-CoV-2 c ‘is the risk of serious heart damage, with the virus continuing to replicate. “
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