Post-BNT Vaccine: Chest Pain, Shortness of Breath, and Heart Concerns

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 15.
On December 16, I felt some discomfort in my chest but didn't pay much attention to it.
On December 20, I visited a large hospital's family medicine department, where my blood tests 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 level 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 shortness of breath; sometimes I need to breathe through my mouth, and I feel pressure on my right chest, and occasionally on my left chest as well.
Sometimes my heart feels like it is fluttering, and I also experience pain behind my heart.
When lying down, both sides of my chest feel constricted, making it a bit difficult to breathe, although it improves slightly when I sleep on my side.
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 sufficient for vaccination.
Will I need another echocardiogram after the second dose? Thank you, Doctor.

Mr. Hong, 30~39 year old female. Ask Date: 2021/12/23

Dr. He Dongjin reply Cardiology

Hello, please do not let the internet be your doctor.
Your situation may be different from that of the general public, so do not self-diagnose.
If you experience chest pain 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 familiar with 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: 2021/12/23

More Info

Post-vaccination symptoms, particularly after receiving the BNT (BioNTech) vaccine, can be concerning, especially when they involve the heart and respiratory system. Your symptoms of chest discomfort, shortness of breath, and the sensation of pressure in your chest are understandably alarming, particularly given your medical history of heart surgery for mitral valve repair.

Firstly, it’s important to acknowledge that while some individuals may experience mild side effects after vaccination, such as soreness at the injection site, fatigue, or mild fever, more serious side effects like myocarditis or pericarditis have been reported, particularly in younger males after mRNA vaccinations. However, these conditions are relatively rare. Your symptoms, including chest pain and shortness of breath, could be related to various factors, including anxiety, musculoskeletal issues, or even a reaction to the vaccine, but they may also indicate an underlying condition that requires further evaluation.

The fact that you have a history of heart surgery adds complexity to your situation. The discomfort you are experiencing could be related to your previous heart condition, especially if you have been experiencing symptoms like palpitations or changes in your heart rhythm. The abnormal lab results you mentioned, particularly the elevated lymphocyte count, could suggest an inflammatory response, but they are not definitive for any specific diagnosis.
Given your symptoms, it is advisable to consult with a cardiologist, especially since you have a history of heart surgery. A thorough evaluation, including an echocardiogram, may be warranted to assess for any potential complications such as pericardial effusion (fluid around the heart) or other cardiac issues. While you mentioned that you had an echocardiogram before your first vaccine dose, it’s important to have updated imaging if your symptoms have changed or worsened.

Regarding your concerns about pericardial effusion, symptoms can include chest pain, shortness of breath, and a feeling of pressure in the chest. However, these symptoms can also be indicative of other conditions, including anxiety or musculoskeletal pain, which can be exacerbated by stress or changes in physical activity. It’s crucial not to jump to conclusions based on anecdotal reports online; instead, rely on professional medical advice tailored to your specific situation.

In summary, while it is possible that your symptoms could be related to the vaccine, they could also stem from your underlying heart condition or other factors. It is essential to follow up with a healthcare provider who can perform the necessary evaluations and provide a comprehensive assessment of your symptoms. In the meantime, monitor your symptoms closely, and if you experience any worsening of your condition, such as increased chest pain, difficulty breathing, or any other alarming symptoms, seek immediate medical attention. Your health and peace of mind are paramount, especially as you prepare for your upcoming plans.

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