We read the article by Dr. Taylor and Dr. Eckart regarding smallpox vaccination-mediated
myocarditis with great interest (
1
). During a recent deployment to Afghanistan, we had a similar case of smallpox vaccine-mediated
myopericarditis that presented as an acute ST-segment elevation myocardial infarction
(MI) on electrocardiogram (ECG). A 27-year-old man presented to our military emergency
department in Afghanistan complaining of acute onset of crushing substernal chest
pain and dyspnea. His symptoms had occurred intermittently for the past 3 days but
became persistent and severe 30 min prior to arrival. Of note, he had arrived in Afghanistan
from the United States (US) 1 week prior. He denied cough, fever, vomiting, or radiation
of pain, and the pain was not positional in nature. He had not experienced any prior
history of similar symptoms. His past medical history was significant only for a smallpox
immunization he received 2 weeks prior to presentation.To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Emergency MedicineAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Chest pain, ST elevation, positive cardiac enzymes in an austere environment: differentiating smallpox vaccination-mediated myocarditis and acute coronary syndrome in Operation Iraqi Freedom.J Emerg Med. 2012; 42: 267-270
- The cause of death in smallpox: an examination of the pathology record.Mil Med. 2002; 167: 546-551
- The global eradication of smallpox: Final report of the global commission for the certification of smallpox eradication. History of International Public Health, No. 4.World Health Organization, Geneva, Switzerland1980
- Smallpox vaccination and myopericarditis: a clinical review.J Am Coll Cardiol. 2004; 43: 1503-1510
- Monitoring the safety of a smallpox vaccination program in the United States: report of the Joint Smallpox Vaccine Safety Working Group of the Advisory Committee on Immunization Practices and the Armed Forces Epidemiological Board.Clin Infect Dis. 2008; 46: S258-S270
- Update: cardiac-related events during the civilian smallpox vaccination program—United States, 2003.MMMR Morb Mortal Wkly Rep. 2003; 52: 492-496
- Myopericarditis following smallpox vaccination.Am J Epidemiol. 2004; 160: 642-651
- ACAM2000: the new smallpox vaccine for United States Strategic National Stockpile.Drug Des Devel Ther. 2010; 4: 71-79
Article info
Publication history
Published online: September 03, 2013
Footnotes
Disclaimer: The views expressed in this article are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.
Identification
Copyright
Published by Elsevier Inc.
