Myocardial Injury and Dysfunction Associated With COVID-19 Vaccination

Inclusion Criteria: 1. age ≥18 years; 2. clear evidence of myocardial involvement including: 1. High Sensitivity Troponin I value of (≥0.05 ng/ml (the 99% upper bound)) OR 2. an LVEF \< 50% OR 3. ST-T change suggesting STEMI, NSTEMI or myopericarditis in the absence of coronary artery disease, OR 4. new onset sustained VT or VF 3. Late gadolinium enhancement or edema on cMRI consistent with myocardial injury or inflammation. 4. Documentation of vaccination with mRNA-based COVID-19 vaccine. 5. No history of COVID-19, or a negative SARS-CoV-2 PCR or other FDA approved laboratory test within 1 week of enrollment. 6. Patient and/or legally authorized representative must be competent to understand and agree with informed consent form. Exclusion Criteria: 1. Hemodynamic instability as evidenced by escalating doses of inotropic agents or vasopressors within the prior 24 hours 2. Respiratory instability as evidenced by increasing oxygen requirements over the 24 hours prior to consent or FiO2 requirement ≥ 60 %. 3. evidence that respiratory failure is the primary reason for myocardial dysfunction; 4. Moderate to severe pulmonary hypertension (mean PAP ≥35 mmHg); 5. INR \>1.8 on no anticoagulation or contraindication to withdrawing anticoagulation; 6. platelets \<100,000/mm3. 7. History of laboratory-confirmed SARS-CoV-2 infection as determined by polymerase chain reaction (PCR) testing or other commercial or public health assay. 8. Acute or chronic kidney disease with glomerular filtration rate \< 30 ml/min.1.72m2