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.