James R. Gill, MD;

Randy Tashjian, MD;

Emily Duncanson, MD

Arch Pathol Lab Med (2022) 146 (8): 925–929.

https://doi.org/10.5858/arpa.2021-0435-SA

Full paper

https://meridian.allenpress.com/aplm/article/146/8/925/477788/Autopsy-Histopathologic-Cardiac-Findings-in-2

Conclusions.—

“The myocardial injury seen in these postvaccine hearts is different from typical myocarditis and has an appearance most closely resembling a catecholamine-mediated stress (toxic) cardiomyopathy. Understanding that these instances are different from typical myocarditis and that cytokine storm has a known feedback loop with catecholamines may help guide screening and therapy.”

“Myocarditis in adolescents (particularly teenage boys) has been reported following the second dose of the Pfizer-BioNTech COVID-19 vaccine.^1–7  Since cardiac biopsies are rarely performed in these instances with clinically stable patients, the myocardial pathology has not been clearly elucidated.⁸  Myocarditis is rarely diagnosed at autopsy in deaths due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.^9,10  The incidence of myocarditis, although low, has been shown to increase after the receipt of the BNT162b2 vaccine, particularly after the second dose among young male recipients.¹¹  In addition, the first week after the second vaccine dose was found to be the main risk window.¹¹  The clinical presentation of myocarditis after vaccination was usually mild.¹¹ “

“We report the autopsy results, including microscopic myocardial findings, of 2 teenage boys who died within the first week after receiving the second Pfizer-BioNTech COVID-19 dose. The microscopic findings are not the alterations seen with typical myocarditis. This suggest a role for cytokine storm, which may occur with an excessive inflammatory response, as there also is a feedback loop between catecholamines and cytokines.¹² “

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Definitive autopsy evidence of vaccine-induced heart inflammation and death, “lethal-vaccine associated myocarditis,” from German pathologists and histologists

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