Society of Diabetic Nephropathy Prevention Journal of Nephropharmacology 2345-4202 14 1 2025 01 01 Presentation of a case of chest pain leading to coronary artery bypass grafting (CABG) following the third dose of COVID-19 vaccination and an overview of the possible causes of chest pain after COVID-19 vaccination e11664 e11664 10.34172/npj.2025.11664 EN Manouchehr Hekmat https://orcid.org/0000-0002-5767-0932 Hamid Ghaderi https://orcid.org/0000-0003-0905-2440 Zahra Ansari Aval https://orcid.org/0000-0002-6044-8259 Naser Kachoueian https://orcid.org/0000-0003-0115-4813 Mahya Hekmat https://orcid.org/0000-0003-0034-800X Roshanak Tirdad https://orcid.org/0000-0002-9764-2303 Seyedeh Adeleh Mirjafari https://orcid.org/0000-0003-2780-6736 Journal Article 10.34172/npj.2025.11664 2023 11 25 2024 01 05 In the wake of widespread COVID-19 vaccinations, a variety of complications have been reported. Among these, cardiac ischemia stands out as a rare, but significant and potentially dangerous complication, which can progress to myocardial infarction and pose a serious threat to one’s life. Our patient was a 54-year-old man with no risk factors, who developed chest pain five days after the third dose of the COVID-19 vaccine. Notably, he exhibited no symptoms after the first and second doses. For four months, the patient’s symptoms were attributed to inflammatory complications, such as pericarditis and myocarditis, as well as gastrointestinal problems. During this period, he received symptomatic treatment. Due to the persistence of symptoms, heart examinations were conducted, which revealed a constriction at the end of the left main coronary artery. Consequently, the patient underwent coronary artery bypass grafting (CABG). Following cardiac revascularization, the patient’s symptoms were successfully alleviated. Furthermore, his cardiac symptoms were successfully resolved during a six-month follow-up period. The mechanism through which asymptomatic plaques in the coronary vessels are activated following the COVID-19 vaccination or infection remains unclear. Regardless of the cause, any chest discomfort experienced after COVID-19 vaccination or infection should be treated with utmost seriousness, and examinations for acute coronary syndrome should be conducted.