1 INTRODUCTION
The coronavirus disease 2019 (COVID-19) pandemic has affected people’s lifestyles, and vaccines have been administered worldwide.
Most COVID-19 vaccines are mRNA-based and are highly effective; however, their adverse reactions have not been entirely clarified. Common side effects include fever, fatigue, headache, or local pain. However, some studies have reported that COVID-19 vaccination exacerbates asthma [1]. In addition, anaphylaxis, takotsubo cardiomyopathy (TTC), myocarditis, and pericarditis have been reported to occur rarely [2]. Therefore, attention should be paid to the emergence of severe side effects after COVID-19 vaccination.
TTC is an acute, reversible myocardial injury induced by emotional or physical stress. Risk factors for TTC include female sex, menopause, and psychiatric disorders. While natural disasters and negative and positive emotions are mental causes, physical causes include trauma, surgery, medications, or intoxication. Respiratory disorders including pneumothorax, chronic obstructive pulmonary disease exacerbation, and bacterial or viral infections; chemotherapy for cancer; and invasive procedures such as bronchoscopy or intubation have been reported as triggers of TTC in patients with respiratory diseases. Moreover, asthma exacerbation and its therapies, such as short- acting β2 agonists (SABAs), adrenaline, or intubation are known to cause TTC [3,4,5]. Fatal complications of TTC include cardiogenic shock, systemic embolism, and heart rupture; hence, TTC should not be missed. However, because respiratory problems often cause dyspnea or chest pain, TTC is difficult to diagnose [6,7].
Here, we report our experience of COVID-19 vaccine-induced asthma exacerbation and TTC in a patient with bronchial asthma.