For additional myopericarditis treatment guidelines, please see DoD Clinical Guidelines
for Post-Smallpox Vaccine Associated Myopericarditis Algorithm (March 2013)
Myopericarditis is defined as a spectrum of disease caused by inflammation of the myocardium (muscle of the heart wall) and/or the pericardium,
which is the sac-like covering surrounding the heart. There is evidence that suggests that some individuals may have this serious cardiac adverse
event following smallpox vaccination.
People most at risk to develop this adverse event are young Caucasian males who are primary vaccinees.
Treatment recommendations for myopericarditis include seeking immediate medical care where an EKG and possibly an Echo can be obtained. Cardiac labs are also recommended.
The MILVAX-VHCN Clinical Services
should be contacted for consultation if a suspected case of myopericarditis is identified.
In addition, the MILVAX-VHCN Clinical Services
maintains the DoD post-smallpox vaccine associated Myopericarditis Registry.
Pre-licensure surveillance with the newer ACAM vaccine revealed occurrence rates similar to Dryvax for myopericarditis.
Cassimatis D, Atwood JE, Engler R, Linz P, Grabenstein J, Vernalis M. (2004) Smallpox vaccination and myopericarditis. JACC;43(9):1503-10.
Eckart R. Love S. Atwood JE, Arness M, Cassimatis D. Campbell C. Boy S. et al. (2004) Incidence and follow-up of inflammatory cardiac complications after
smallpox vaccination. JACC;44(1):201-5.
Helle, E.J., Koskenvuo, K., Pikkarainen, J. & Weckstrom, P. (1978). Myocardial complications of immunizations. Annuals of Clinical Research;10:280-287.
Karjalainen J, Heikkila J, Nieminen MS, Jalanko H, Kleemola M, Lapinleimu K, Sahi T. (1983). Etiology of mild acute infectious myocarditis:
Relation to clinical features. Acta Medica Scandinavica;213:65-73.