ITN’s Top 10 for the Month of February

COVID-19 vaccine associated myocarditis. Short-axis 1.5T MRI images and ECG findings of a 19-year-old man with myopericarditis who presented with chest pain 3 days following the second dose of an mRNA COVID-19 vaccine (mRNA-1273). Cardiac MRI performed 2 days after symptom onset demonstrates mid wall to subepicardial late gadolinium enhancement (LGE) at the basal to mid inferior lateral wall with adjacent pericardial enhancement (A, red arrow), corresponding hyperintensity on T2-weighted imaging (B, orange arrows), abnormal high native T1 (C, 1095 ms, maximum region of interest), and abnormal high native T2 (D, 57 ms, maximum region of interest). The ECG demonstrates diffuse concave upward ST segment elevation except in leads aVR and V1, upright T waves in the leads with ST segment elevation, and PR depression, consistent with pericarditis (E). Peak high sensitivity troponin-I was 5772 pg/mL. He was admitted to hospital and was discharged after two days following complete resolution of his symptoms. At short-interval follow-up he was asymptomatic with normal troponin levels. Image courtesy of the Radiological Society of North America