An autopsy case report of aortic dissection complicated with histiolymphocytic pericarditis and aortic inflammation after mRNA COVID-19 vaccination. (November 2022)

• Record Type: Journal Article
• Authors: Takahashi, Motonori; Kondo, Takeshi; Yamasaki, Gentaro; Sugimoto, Marie; Asano, Migiwa; Ueno, Yasuhiro; Nagasaki, Yasushi
• Is Part Of: Legal medicine. Volume 59(2022)
• Publication Date: 2022-11
• Subjects: COVID-19 -- SARS-CoV-2 -- Vaccine -- Cardiac complication; Medical jurisprudence -- Periodicals; Forensic Medicine -- Periodicals; Médecine légale -- Périodiques; Medical jurisprudence; Periodicals; 614.1
• DOI: 10.1016/j.legalmed.2022.102154
• Languages: English
• ISSNs: 1344-6223

Abstract

Highlights: An autopsy case report of pericarditis after COVID-19 vaccination is presented. Extended inflammation of the aortic wall was histologically confirmed. Macrophages and lymphocytes infiltrated, along with a small number of eosinophils. Abstract: A male in his 90 s consulted a doctor because he experienced several days of general fatigue and dyspnea. He was diagnosed with heart failure, and diuretic medications taken for 3 days relieved his symptoms. However, he was found dead on the morning of the fourth day after consultation. He had received a third dose of coronavirus disease 2019 (COVID-19) vaccine approximately 2 weeks before death. An autopsy revealed dissection of the ascending aorta and pericardial hemotamponade. The heart showed a white villous surface, and the pericardium was fibrously thick. Microscopic examination revealed pericarditis with predominantly macrophage and lymphocyte infiltration. These histological findings were compatible with those of post-vaccination myocarditis. To the best of our knowledge, histopathologically proven pericarditis after COVID-19 vaccination has not been reported. In the present case, extended inflammation of the aortic adventitia was a possible cause of aortic wall fragility followed by dissection.