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.