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she thought it was a heart attack; it was a rare vaccine reaction
myocarditis after mrna covid-19 vaccination is a rare adverse event that often resolves quickly, without treatment.
jul 6 2021
4 minute read
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by: elizabeth payne
on march 11, shirley graves did what she does every day — walked to the barn to do chores. but this was no ordinary morning. by the time she got there, she had a burning pain in her chest and was sweating profusely. the retired nurse was convinced she was having a heart attack.
fearing she was “going down,” graves laid on the concrete floor and mustered the energy to phone her husband and ask him to call an ambulance.
it turned out that graves did not have a heart attack. tests done at queensway carleton hospital quickly ruled that out. but it would take days before the active 68-year-old had a diagnosis: she was suffering from myocarditis, inflammation of the heart muscle, a rare adverse event linked to the pfizer covid-19 vaccination she had been given just days earlier.
graves says she was lucky to eventually get referred to dr. peter liu, chief scientific officer at the university of ottawa heart institute. at the time, the connection between mrna covid-19 vaccines and the rare side effect were not widely known, but liu, who specializes in myocarditis, had been hearing about cases first reported in israel. he immediately sent graves for an mri, which confirmed heart inflammation. liu said he is convinced the myocarditis is linked to the vaccine. both her family doctor and the public health unit where she lives had earlier missed the connection with the vaccine.
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myocarditis after mrna covid-19 vaccination is a rare adverse event that often resolves quickly, without treatment. that has not been the case for graves, though. the first three or four weeks after diagnosis was “pretty rough,” impacting her life and terrifying her family. four months later, she still has occasional episodes that have sent her back to the hospital for further monitoring. liu has suggested she begin taking anti-inflammatory medicine for any future episodes.
graves and others say myocarditis must be on the radar of health officials, especially with vaccinations ramping up quickly among people in their teens and 20s. it most commonly affects younger men, and usually occurs after a second dose. graves’ reaction was after her first dose.
liu said things are beginning to change, especially as a growing number of people get their second doses. in the past few weeks, he and his colleagues have diagnosed around 15 cases at the heart institute, he said, the most recent on monday. the cases follow a pattern, he said; usually between two and four days after getting a vaccination, patients go to the hospital with symptoms that include chest pain and shortness of breath. they usually require hospitalization and treatment with anti-inflammatories and their symptoms usually resolve quickly.
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as of mid-june, 65 cases of myocarditis or pericarditis (inflammation of the pericardium that surrounds the heart) had been reported to health canada. some health officials concede that cases have likely been missed.
in renfrew county, acting chief medical officer dr. robert cushman is working to make sure cases there are not missed. he reviews reports of adverse events once or twice a week and makes sure anyone reporting chest pain, shortness of breath or anything cardiac related after a vaccination is investigated for possible myocarditis or pericarditis. cushman, who is also chairman of the ottawa heart institute research corporation, has referred a handful of cases to liu, who is a leading canadian expert.
that is what he did after hearing about graves’ case from mutual friends who were concerned about her back in march.
“something was wrong. it didn’t pass the sniff test,” he said of her case. when cushman described the case to liu, the cardiologist told him about myocarditis cases being reported in israel after pfizer vaccinations and said, “this may be our first case in eastern ontario.”
in normal times, cases of myocarditis and pericarditis occur in the population at rates of about 1.5 per 100,000 people. that increased to close to three cases per 100,000, according to israeli research on cases after mrna covid-19 vaccines.
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“it is still very rare and very uncommon,” said cushman, noting that driving to the clinic is likely riskier.
but being vigilant means that cases get quick attention when they are identified.
graves says her experience is no reason for people to fear covid-19 vaccines.
“i don’t want people to get pfizer vaccine hesitancy because of what i experienced, but the medical community needs to know that if someone presents (with these symptoms) they need to recognize it as a possible reaction to a pfizer vaccine.”
the former nurse-manager at the civic hospital convinced her son, in his 30s, to get his second dose after her experience worried him. after being told that she could not get a second mrna vaccine, graves chose to get astrazeneca.
“it is a perfectly good vaccine. i had a couple of days of needing a nap, but was otherwise fine.”
the woman, who seldom walks less than 15,000 steps a day working on the farm where she and her husband breed polled dorset sheep, said myocarditis temporarily sidelined her, but now she is able to continue the work she loves, with ongoing monitoring.
she said she is indebted to her friends — both medical professionals — with whose help she was eventually seen by liu and diagnosed.
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“if i hadn’t gotten connected with dr. liu, it would have been life-changing.”
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