Vaccine-Related Myocarditis Severity Triage Score (VRMST) Calculator
- Vaccine-Related Myocarditis Severity Triage Score (VRMST): Explanation and Clinical Context
This calculator estimates bedside severity for suspected vaccine-associated myocarditis using routinely available clinical data. The proposed VRMST score prioritizes factors that consistently track with worse short-term outcomes in myocarditis—hemodynamic instability/shock, depressed left ventricular function, malignant ventricular arrhythmias or high-grade atrioventricular block, and tamponade physiology—while also incorporating myocardial injury (high-sensitivity troponin ratio) and systemic inflammation (CRP). ECG ST-segment changes and cardinal symptoms add modest weight to capture less fulminant disease. Scores of 0–3 suggest a mild course where short observation or outpatient follow-up may be reasonable if vitals and biomarkers remain stable; 4–7 indicates moderate severity warranting admission and continuous telemetry; ≥8 flags severe disease prompting ICU-level care and urgent cardiology input. This tool is derived from published pathways and consensus statements for myocarditis (including post-mRNA vaccination), but it is not a validated prognostic score and should not replace clinical judgment, local protocols, or shared decision-making.
Reference:
2024 ACC Expert Consensus Decision Pathway on Myocarditis and Pericarditis. J Am Coll Cardiol. 2024/2025 online ahead of print.
Sandeep N, et al. J Am Heart Assoc. 2022;11:e026097.
CDC. Myocarditis after COVID-19 Vaccines. Accessed 2025.
Patone M, et al. Circulation. 2022;146: (online).
Deng L, et al. npj Vaccines. 2025.
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