Chest Pain and Breathing Issues After BNT Vaccine: What to Know

After receiving the BNT vaccine, I experienced chest tightness, chest pain, and some difficulty breathing?

Hello Doctor: I received my second dose of the BNT vaccine on December 15th.
On December 16th, I felt some discomfort in my chest but did not pay much attention to it.
On December 20th, I visited a large hospital's family medicine department, where my blood test results showed a white blood cell count of 6.61, platelet count of 280, basophils at 0.6, eosinophils at 4.2, lymphocytes at 53.4 (abnormal), monocytes at 5.4, and neutrophils at 36.4 (abnormal).
My D-Dimer was 114, creatine phosphokinase was 85, and creatine phosphokinase-MB was 11.
I also had an electrocardiogram, and the doctor said there were no abnormalities.
I had heart surgery last year to repair my mitral valve, and the doctor suggested that my chest pain and discomfort might be related to that.
However, I am now experiencing some difficulty breathing; sometimes I have to breathe through my mouth, and I feel pressure in my right chest, and occasionally in my left chest as well.
Sometimes my heart feels like it is fluttering, and I also experience pain behind my sternum.
When lying flat, I feel pressure on both sides of my chest, making it somewhat difficult to breathe, although sleeping on my side helps a bit.
I have come across many cases online where individuals developed pericardial effusion after receiving the BNT vaccine, which can only be detected through an echocardiogram.
I would like to ask the doctor if my symptoms resemble those of pericardial effusion.
I am a bit worried and am considering whether I should see a cardiologist for an echocardiogram.
However, I had an echocardiogram before receiving the first dose, which was deemed acceptable for vaccination.
Will I still need another echocardiogram after the second dose? Thank you, Doctor.

Mr. Hong, 30~39 year old female. Ask Date: 2021/12/22

Dr. He Dongjin reply Cardiology

Hello, please do not let the internet be your doctor.
If your situation is different from that of the general public, do not self-diagnose.
If you experience chest pain, tightness, or discomfort, please return to your primary care physician.
A family medicine doctor may not fully understand your condition, and I may not either.
Your primary care physician should be aware of your situation and how to manage it.
As for what tests to perform, it is best to respect the professional judgment of your primary care physician in making those arrangements.
Changhua Hospital cares about you.

Reply Date: 2021/12/22

More Info

After receiving the BNT vaccine, it is not uncommon for individuals to experience various side effects, including chest pain and breathing difficulties. Your symptoms, which include a sensation of pressure in the chest, difficulty breathing, and occasional heart palpitations, warrant careful consideration. While some discomfort can be attributed to the vaccine, it is essential to differentiate between vaccine-related side effects and other potential medical conditions.

Firstly, it is important to note that vaccines, including the BNT (Pfizer-BioNTech) COVID-19 vaccine, can cause transient side effects such as soreness at the injection site, fatigue, headache, and muscle pain. These symptoms typically resolve within a few days. However, persistent symptoms, especially those involving the chest and breathing, should not be overlooked.
Your medical history, particularly the previous heart surgery and the placement of a mitral valve ring, adds complexity to your situation. Given that you have experienced chest pain and difficulty breathing after your second vaccine dose, it is crucial to consult with a healthcare professional who understands your medical history. While your initial tests, including blood counts and an electrocardiogram (ECG), showed no abnormalities, the presence of ongoing symptoms suggests that further evaluation may be necessary.

Concerns about pericardial effusion (fluid around the heart) following vaccination have been reported, although they are relatively rare. Symptoms of pericardial effusion can include chest pain, difficulty breathing, and a feeling of pressure in the chest. However, these symptoms can also be indicative of other conditions, such as anxiety, musculoskeletal pain, or even gastroesophageal reflux disease (GERD). Therefore, it is essential not to jump to conclusions based solely on online information.

In your case, since you are experiencing significant discomfort and difficulty breathing, it would be prudent to consult a cardiologist. They may recommend further imaging studies, such as an echocardiogram, to assess for any potential complications related to your heart or the pericardium. Given that you had an echocardiogram before your first vaccine dose, it is reasonable to have another one to compare any changes that may have occurred.

Additionally, if you find that your symptoms worsen or if you experience new symptoms such as severe shortness of breath, dizziness, or fainting, you should seek immediate medical attention. It is better to err on the side of caution, especially with a history of heart surgery.

Regarding your question about receiving the flu vaccine next month, it is generally safe to receive other vaccines after the COVID-19 vaccine, provided you are not experiencing severe symptoms that would warrant further medical evaluation. However, discussing this with your healthcare provider is advisable to ensure that your overall health status is taken into account.

In summary, while some side effects after vaccination are normal, persistent symptoms such as chest pain and difficulty breathing should be evaluated by a healthcare professional. Given your medical history, a cardiologist's assessment may provide clarity and peace of mind. Always prioritize your health and do not hesitate to seek medical advice when in doubt.

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