The advent of vaccines against COVID-19 has been major stride forward towards quelling the pandemic, with India leading from the front by successfully running the world’s largest vaccination campaign. Currently Covishield (AZD1222) and Covaxin (BBV152) are in circulation in India. Recently there are speculations, stray newspaper reports and preprints on vascular thromboembolic catastrophes post-vaccination, especially with AstraZeneca vaccine [1e3]. There is single case report of myocardial infarction (MI) after the Moderna vaccine [4] and deep vein thrombosis following second dose of Pfizer vaccine [5]. Here, we report a case of MI following Covishield vaccination with the sole purpose of generating awareness among clinicians regarding this possible rare major adverse event and unfurling the possible pathophysiology behind it.

A previously healthy 63-year-old man presented to the emergency with complaint of chest pain for last 6 hours. He was nonhypertensive, non-diabetic, and devoid of any other traditional risk factors of cardiovascular diseases including smoking. He had history of taking first dose of Covishield vaccine 2 days back and since then he developed uneasiness, dizziness and excessive sweating. On examination, he was hemodynamically stable, with 12 lead electrocardiogram (ECG) showing ST elevation in leads II, III and aVF (Fig. 1) suggestive of acute ST elevated inferior wall myocardial