This article presents two case reports, an adult and a child with vasospastic angina after a COVID mRNA injection.
Angina is chest pain due to an arterial blockage. The most common cause is atherosclerosis and a blood clot (thrombosis) in the coronary artery.
Angina can also be due to a spasm of the coronaries due to the Pfizer mRNA COVID shots.
Report about a 41-year old
A 41-year-old Japanese male smoker with no medical history received the first dose of the Pfizer mRNA shot.[1]
One week after vaccination, he developed chest pain and palpitations after drinking alcohol. He had never experienced chest pains before his COVID-19 vaccination.
Because of the repeated chest pains, he sought a medical consult and was admitted to the Toho University Ohashi Medical Center in Tokyo on the 11th day after vaccination.
At the hospital, his chest pain was resolved. His electrocardiogram (ECG) and echocardiogram were normal.
Blood markers of heart muscle injury (troponin and creatine kinase) did not indicate heart damage.
Due to the history of developing angina after alcohol consumption, the doctors suspected vasospastic angina, which was confirmed by an acetylcholine provocation test.
The acetylcholine provocation test made his coronaries undergo spasms documented by an angiogram.
The yellow arrows below point to the constriction of the coronary arteries after injection with acetylcholine (Ach).
The black arrows on the EKG point to an ST-T elevation. The EKG abnormalities happened at the same time as the coronary spasms.
If someone with chest pain goes to an emergency room and his EKG has ST-T elevations, the impression will be a heart attack, and they will go to the cardiac cath lab or get a drug to dissolve a blood clot.
Like atherosclerosis and thrombosis, coronary spasms in this patient can lead to a myocardial infarction if the vasospastic angina is not corrected. Luckily, it was averted with the proper diagnosis.
He was treated with a calcium channel blocker to prevent spasms and discharged the next day.
Pfizer-induced Vasospasm in a Child
The journal Cardiology in the Young, published in January 2023, published a case of a 13-year-old. He started having repeated chest pains 36 hours after the second dose of the Pfizer BNT162b2 shot. [2]
His cardiac enzymes were elevated, indicative of myocarditis. A cardiac MRI and coronary angiography with acetylcholine provocation also confirmed vasospastic angina. [2]
The whole article is not available for free. I assume the child was treated adequately because they made the correct diagnosis.
Mechanism of Vasospasm
The authors of the first study offered several suggestions on why coronary vasospasm could happen after the mRNA shots. [1]
The ACE2 receptor in the human body is needed to convert the protein angiotensin II to a vasodilator. The SARS-CoV-2 spike protein or the mRNA of the vaccine can downregulate or decrease the number of ACE2.
The vasodilator’s absence upsets the balance and ultimately ends in vasoconstriction.
Inflammation with the activation of Rho-kinase can cause hypercontraction of the smooth muscles in the coronary arteries and induce spasms.
40 % of East Asians, like the adult case report here, have alcohol flushing syndrome, where the face gets red with alcohol intake.
In alcohol flushing syndrome, toxic metabolites like aldehydes are formed and cause vasoconstriction.
Substances in the mRNA vaccine, like the lipid nanoparticle and polyethylene glycol, can cause an allergic reaction called Kounis syndrome. Histamine is released in Kounis syndrome and causes coronary vasospasm. I wrote about it in
Kounis syndrome can explain vaccine-related heart attacks
Take away message
Coronary vasospasm should be considered in adults and children who develop repeated chest pains and palpitations after COVID-19 jabs.
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References:
- Awaya T, Moroi M, Nakamura F, Toi S, Wakiya M, Enomoto Y, Kunimasa T, Nakamura M. A Possibility of Vasospastic Angina after mRNA COVID-19 Vaccination. Vaccines (Basel). 2022 Nov 24;10(12):1998. doi: 10.3390/vaccines10121998. PMID: 36560408; PMCID: PMC9786293.
- Tanaka A, Fukuoka S, Nagata H. Vasospastic angina following COVID-19 vaccine-related myocarditis: an underlying cause of chest pain. Cardiol Young. 2023 Jan 11:1-3. Doi: 10.1017/S1047951122003389. Epub ahead of print. PMID: 36628632.
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