Military.com was the first to report incidents of myocarditis in Americans following vaccination in the U.S., after the Israeli Health Ministry announced it was exploring a possible link. 2007;116:2216. Your email address will not be published. AskMayoExpert. "Evidence available in peer-reviewed literature suggests that cardiac risk of complications are clearly higher in those with COVID-19 disease as opposed to a potential risk from the COVID-19 vaccine.". Careers. Centers for Disease Control and Prevention. The DoD has logged more than 284,000 cases of COVID-19 since the beginning of the pandemic, including troops, family members, employees and contractors. 2021 Dec 1;6(12):1446-1450. doi: 10.1001/jamacardio.2021.3471. Careers. It's a finding Defense Department researchers say should call attention to the condition, known as myocarditis, as a potential side effect of the immunizations. $("mega-back-deepdives .mega-sub-menu").show(); However, it may also be the result of autoimmune activation, chemical or pharmacological toxins, environmental insult or hypersensitivity reactions. We recently described a case of COVID-19 myopericarditis with an associated pericardial effusion and cardiac tamponade.3 The initial diagnosis of COVID-19 myocarditis was made clinically, with evidence of worsening left ventricular (LV) function, in association with a positive RT-PCR for SARS-CoV-2 RNA. All rights reserved. When gender was reported, males accounted for 82% of the myocarditis cases. This material may not be published, broadcast, rewritten, Disclaimer. COVID-19 Associated Myopericarditis: Key Lessons Elsevier; 2019. https://www.clinicalkey.com. The aetiology is usually the result of a number of infectious aetiologies with viruses being the most common pathogens in the vast majority of cases. 2023 Feb;42(2):161-167. doi: 10.1016/j.repc.2023.01.003. Bethesda, MD 20894, Web Policies The patient made a full recovery and was discharged from hospital alive. Patients With Acute Myocarditis Following mRNA COVID-19 Vaccination. Mayo Clinic; 2021. Cooper LT. Clinical manifestations and diagnosis of myocarditis in adults. Limitations of the study conducted by Oster et al include that VAERS is a passive reporting system with possibly incomplete data of variable quality, inability to obtain medical records or interview some physicians, and the lack of clinical review. You've successfully subscribed to this newsletter! $(".mega-back-specialties").removeClass("mega-toggle-on"); When children develop myocarditis, symptoms may include: Contact your health care provider if you have symptoms of myocarditis. A greater number of heart inflammation cases cropped up among members of the U.S. military than expected following mRNA COVID-19 vaccination, a study found, though authors emphasized the benefits of the shots exceed risks of rare adverse events. 2013 Jul;29(3):465-83. doi: 10.1016/j.ccc.2013.03.004. Epub 2015 Aug 5. He added that reports of myocarditis following COVID-19 vaccines do not change the DoD's recommendations that all patients in the military health system get the COVID-19 vaccine "as soon as possible. The Defense Health Agency published findings in the JAMA Cardiology journal, noting 23 otherwise healthy male patients presented with chest pain within four days after either the Pfizer-BioNTech or Moderna vaccine. He added that discussions are ongoing among subject matter experts. 2023 FOX News Network, LLC. If you are having unexplained chest pain and shortness of breath, seek emergency medical help. The U.S. has administered more than 228 million doses of COVID-19 vaccines of all types, including Pfizer, Moderna and Johnson & Johnson, according to the CDC. The U.S. military has also studied myocarditis after the smallpox vaccine and found a significant link.. The condition is treatable but can lead to heart attack or stroke or cause chronic thickening of the heart muscles. Myocarditis is most frequently diagnosed in young adults ages 20 to 40, according to the National Organization for Rare Disorders. Also sometimes out of know where my heart rate will be high. Follow her on Twitter @patriciakime. BMJ Case Rep. 2018 Mar 22;2018:bcr2017223523. Among 8 patients who underwent cardiac magnetic resonance imaging within the acute phase of illness, all had findings consistent with the clinical diagnosis of myocarditis. At A Glance: Man develops symptoms 10 days after Moderna vaccine; dies 2 days later. You may opt-out of email communications at any time by clicking on The VAERS review identified 1,991 reports of myocarditis and 1,626 met the CDCs case definition. Lopez-Jimenez F (expert opinion). https://www.mayoclinic.org/diseases-conditions/coronavirus/in-depth/coronavirus-vaccine/art-20484859. Men develop myocarditis more frequently than women, "possibly due to effects of testosterone on the immune reaction to infection, according to NORD. https://www.cdc.gov/flu/prevent/actions-prevent-flu.htm. Particular aetiologies that are more likely to be seen in a military population are discussed and include certain infections, smallpox vaccine, and hyperthermia and hypothermia. Most were seen in men under age 30; 56 of the 62 cases occurred after the second vaccine dose. The authors of the military . National Library of Medicine Search our network of Health Restoration Clinics that are thinking and acting differently to solve the health challenges others cant. The CDC took steps to recommend that people with known heart disease avoid the smallpox vaccination. 2022; doi:10.1016/j.hlc.2022.02.002. other information we have about you. $("mega-back-specialties .mega-sub-menu").show(); eCollection 2022 Dec. Temporal Associations Between Immunization With the COVID-19 mRNA Vaccines and Myocarditis: The Vaccine Safety Surveillance System Is Working. Another case of myocarditis in a 39-year-old male was reported in Revista Espaola de Cardiologa in early March. Troponin is a biomarker that indicates heart damage or a heart attack. All military members were previously healthy with a high level of fitness. CDC officials added that they had not yet determined how the vaccines cause myocarditis. Doctors used MRI evidence and troponin levels to support a diagnosis of myocarditis. Limor Friedensohn, M.D., from the Israel Defense Forces, and colleagues examined whether a third . COVID-19: Get the facts. Recovery, depending on the initial reason for development, can take up to several weeks but it also may linger for months, reducing a patient's ability to work out or engage in physically strenuous activities, including military training and exercises. jQuery(function($) { In a separate study, published online Jan. 24 in Annals of Internal Medicine, researchers reported findings from one of the first case-control studies analyzing myocarditis and related carditis risk associated with the BNT162b2 vaccine and the CoronaVac inactivated virus vaccine. There are two key studies on what the real rates of post COVID-19 vaccine heart damage may actually be: Prospective Thailand study of 202 boys showed 1:30 (7/202) boys ages 13-17 developed myocarditis or pericarditis within a week after 2nd dose of Pfizer COVID-19 mRNA (). Using nationwide hospital discharge and vaccine data, we analysed all 1612 cases of myocarditis and 1613 cases of pericarditis that occurred in France in the period from May 12, 2021 to October 31 . Myocarditis can cause chest pain, shortness of breath, and rapid or irregular heart rhythms (arrhythmias). Mankad R (expert opinion). https://www.uptodate.com/contents/search. A new study of U.S. service members found higher than expected rates of heart inflammation following receipt of COVID-19 vaccines. The vaccinations had been administered between January 1 and April 30, 2021.. Furthermore, a German cohort of 100 patients recently recovered from COVID-19 demonstrated that 60% of patients had evidence of myocardial inflammation. In addition to conditions such as immunosuppression, active cancer, and pre-existing respiratory pathology, cardiovascular comorbidities are also important, particularly diabetes mellitus and hypertension. Follow her on Twitter @patriciakime. $(".mega-back-mediaresources .mega-sub-menu").hide(); Both the Moderna and Pfizer vaccines had been used. Military myocarditis patients are being advised not to exercise for three to six months; to limit carbohydrates and sugar to reduce inflammation; and to restrict themselves to no more than one alcoholic beverage a day. Myopericarditis after messenger RNA Coronavirus Disease 2019 Vaccination in Adolescents 12 to 18Years of Age. In this case series, myocarditis occurred in previously healthy military patients with similar clinical presentations following receipt of an mRNA COVID-19 vaccine. RV strain due to lung involvement and/or pulmonary emboli, a type 2 myocardial infarction due to hypoxemia or secondary to a systemic inflammatory response), rather than direct myocardial injury or inflammation causing myocarditis. Conclusions and relevance: 2023 FOX News Network, LLC. "Mayo," "Mayo Clinic," "MayoClinic.org," "Mayo Clinic Healthy Living," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research. g. Persistent tachycardia (resting pulse rate of 100 or greater . The VAERS study was funded by the CDC, Boston Medical Center, Cincinnati Childrens Hospital Medical Center, and Vanderbilt University Medical Center with the US Centers for Disease Control and Prevention (CDC) Clinical Immunization Safety Assessment Project. Many viruses have been linked to myocarditis, including those that cause the common cold (adenovirus); COVID-19; hepatitis B and C; parvovirus, which causes a mild rash, usually in children (fifth disease); and herpes simplex virus. Exposure: There is a problem with Accessed March 23, 2022. Read Next: The VA is Testing an Implant that Could Help Paralyzed Veterans Walk Again. All patients had significantly elevated cardiac troponin levels. According to the 1995 World Health Organization task force on cardiomyopathies, myocarditis is an inflammatory disease of the myocardium that is diagnosed on the basis of established . applied a warning to the mRNA vaccines regarding myocarditis., https://jamanetwork.com/journals/jamacardiology/fullarticle/2781602, https://www.military.com/daily-news/2021/06/30/dod-confirms-rare-heart-inflammation-cases-linked-covid-19-vaccines.html, https://www.timesofisrael.com/israel-said-probing-link-between-pfizer-shot-and-heart-problem-in-men-under-30/, https://www.reuters.com/world/middle-east/israel-examining-heart-inflammation-cases-people-who-received-pfizer-covid-shot-2021-04-25/, https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0118283, FDA to Add Warning for Myocarditis to COVID Vaccines, Cases of Myocarditis in Military After COVID-19 Vaccine, Man Dies From Blood Clots Associated With Moderna Vaccine, Vaccine Manufacturers, CDC Dont Agree on Boosters, 7.3.21 Health Freedom with Dr. Patrick Flynn Recap, Delta Variant Causes WHO to Urge Masks for Fully-Vaccinated. Mouch SA, et al. -- Patricia Kime can be reached Patricia.Kime@Monster.com. eCollection 2022 Nov. Sheriff MM Sr, Basalib SG, Mereani MJ, Bakhsh LM, Alzamzami BA, Garout RM. In April, Pfizer was questioned about the increase in cases of myocarditis reported in Israel following use of the vaccine. Nature Communications. An official website of the United States government. The case-control study was funded by a research grant from the Food and Health Bureau, The Government of the Hong Kong Special Administrative Region. }); Gastrointestinal infections (echoviruses), mononucleosis (Epstein-Barr virus) and German measles (rubella) also can cause myocarditis. Cureus. But 20 military members developed inflammation after their second dose, including 14 after the Moderna shot and six after the Pfizer shot. Related: The Military Faces of COVID-19: 5 Stories of Lives the Community Lost to The Virus. Most myocarditis is infectious in aetiology, but other militarily relevant causes are also seen. Of those, 344 people died, including 24 troops and 12 dependent family members. Due to hypotension unresponsive to intravenous fluid, the patient underwent pericardiocentesis. A Journal of American Medical Association (JAMA) report on myocarditis among members of the U.S. military following mRNA COVID-19 vaccinations found that 23 male patients developed myocarditis . "Potential mechanisms for myocarditis post-mRNA-based vaccination include a non-specific innate inflammatory response or a molecular mimicry mechanism between viral spike protein and an unknown cardiac protein," wrote Dr. Kathryn Larson. Although the absolute risk is very low, this elevated risk should be made known to vaccine recipients and physicians and be weighed against the benefits of vaccination.. 2021; doi:10.1016/j.vaccine.2021.05.087. The Maj. Richard Star Act would eliminate the dollar-for-dollar offset on retirement pay that combat-disabled vets with less Capt. Analysis of the pericardial fluid revealed a sterile exudate, which was negative for SARS-Cov-2 RNA. FOIA Background A full 90% of myocarditis events occurred within 7 days. Of more than 5 million vaccines administered in Israel, 62 cases of myocarditis were recorded days after vaccination. All of the men were considered healthy prior to vaccination, physically fit, and met the criteria for active duty service. Crit Care Clin. }); Myocarditis in systemic immune-mediated diseases: Prevalence, characteristics and prognosis. Myocarditis is an inflammation of the heart muscle and pericarditis is an inflammation of the lining that surrounds the heart. To describe myocarditis presenting after COVID-19 vaccination within the Military Health System. JAMA Cardiol. A total of 20 patients had symptom onset following the second dose of an appropriately spaced 2-dose series. The analysis of 160 myocarditis cases and 1,533 controls showed an elevated risk for carditis observed in recipients of BNT162b2 vaccine but not the inactivated virus vaccine. The crude reporting rates for cases of myocarditis within 7 days after Covid-19 vaccination exceeded the expected rates of myocarditis across multiple age and sex strata, the researchers wrote. An official website of the United States government. The site is secure. 2022 Jun 1;5(6):e2218505. Myocarditis secondary to smallpox vaccination. The presenting symptom was chest pain in 82% of cases. At The Wellness Way, were dedicated to finding the answers you need. Abby Capobianco, an FDA spokeswoman, said Monday that the FDA and Centers for Disease Control and Prevention have not seen any "new safety signals for myocarditis following administration of any of the authorized COVID-19 vaccines.". All rights reserved. If we combine this information with your protected The degree of cardiac involvement is not necessarily related to the severity respiratory involvement, i.e. This creates specific limitations on how the data can be used scientifically," VAERS notes on its web page. Myocarditis following COVID-19 mRNA vaccination. Of the 14 cases, one patient, who tested positive for COVID-19 three months ago, developed myocarditis after their first dose of vaccine. Disclaimer. Meta-analysis suggests that approximately 5% of patients with COVID-19 who undergo computed tomography (CT) chest for clinical indications have a detectable pericardial effusion.12 Analysis of aspirated pericardial fluid is important in the investigation of any patient with cardiac tamponade. Even though almost all individuals with cases of myocarditis were hospitalized and clinically monitored, they typically experienced symptomatic recovery after receiving only pain management. Kaiser Health News is a nonprofit news service covering health issues. Differentiating myocarditis from other causes of chest pain typically requires an ECG, biomarkers and cardiac imaging. FOIA Powered and implemented by FactSet Digital Solutions. There was no indication of previous COVID-19 infection or any other infection that may have led to the heart inflammation. -- Patricia Kime can be reached at Patricia.Kime@Monster.com. The remaining 13 patients developed myocarditis after their second vaccine doses. Copyright 2023 Military.com. This site complies with the HONcode standard for trustworthy health information: verify here. Legal Statement. Like I can feel it or see my stomach move with my heart beat. Multivariable analyses showed that recipients of the BNT162b2 vaccine had higher odds of carditis (adjusted odds ratio [OR], 3.57; 95% CI, 1.93-6.60) compared to people who were unvaccinated. Cardiac symptoms resolved within a week of onset for 16 patients, but seven continued to have chest pain at the time of publication. Moderna did not respond to an email sent Feb. 23 by Military.com about the military cases. While 16 patients saw symptoms resolve within a week, seven were still experiencing chest discomfort at the time the study was submitted for publication. Their VAERS data study was published online Jan. 25 in JAMA. 2021 Oct 1;6(10):1196-1201. doi: 10.1001/jamacardio.2021.2828. COVID vaccines and heart inflammation in young adults a 'likely' link: CDC panel. The incidence of carditis per 100,000 doses of CoronaVac and the mRNA vaccine administered respectively was estimated to be 0.31 (95% CI, 0.13-0.66) and 0.57 (CI, 0.36- 0.90), respectively. I get pain in my left chest, sometimes center, and it comes once a day at anytime. In 2003, at least 10 military personnel and several civilians developed myocarditis after receiving the vaccine; two died of heart attacks. In 2003, at least 10 military personnel and several civilians developed myocarditis after receiving the vaccine; two died of heart attacks. This retrospective case series studied patients within the US Military Health System who experienced myocarditis after COVID-19 vaccination between January and April 2021. Braswell-Pickering EA. Cases of Myocarditis in Military After COVID-19 Vaccine Articles July 1 , 2021 At a Glance: On June 29, 2021, the JAMA Network released a study of military men with confirmed cases of myocarditis following COVID-19 vaccines. All rights reserved. Pericardial Fluid Analysis of Effusate Physicians would have expected to find eight or fewer cases of myocarditis among the 436,000 male military members who received two mRNA shots, according to the study. Myocarditis and pericarditis after mRNA COVID-19 vaccination. The https:// ensures that you are connecting to the In a presentation last week by the CDC's vaccine advisory panel, officials said the rate of developing myocarditis was 12.6 per 1 million people vaccinated. As of June 11, 2021, 226 reported cases in patients 30 years or younger had met the Centers for Disease Control and Prevention's (CDC's) working case definition for myocarditis or pericarditis. ; Professor Christian Mueller, University Hospital Basel Switzerland conducted testing on 777 healthcare workers within a . government site. The military administered more than 2.8 million doses of mRNA COVID-19 vaccine in this period. A review by Military.com of the Food and Drug Administration's Vaccine Adverse Event Report System, or VAERS, database as of Friday showed at least 45 reports of myocarditis following COVID-19 vaccines. Epub 2023 Jan 5. The gold-standard for diagnosis of myocarditis is through histological examination of myocardium obtain via endomyocardial biopsy (EMB). Cheng CY, et al. Heart Rhythm. COVID-19 Vaccination-Associated Myocarditis: A Literature Review. https://www.uptodate.com/contents/search. Major presenting symptoms, including chest pain (89%) and shortness of breath (29.6%), tended to resolve more quickly than more typical cases of myocarditis unrelated to Covid-19 vaccination, wrote Centers for Disease Control and Prevention researcher Matthew Oster, MD, Atlanta, Georgia, and colleagues. a patient can be extremely unwell with COVID-19 associated myopericarditis, yet have relatively little lung involvement, as was the case with the first case at our institution. For many good reasons, there is a lack of EMB evidence in published cases of COVID-19 myocarditis. }); Federal government websites often end in .gov or .mil. This content does not have an Arabic version. $(".mega-back-deepdives").removeClass("mega-toggle-on"); Following the meeting, the FDA announced revisions to fact sheets accompanying the Pfizer and Moderna COVID-19 vaccines relating to elevated risks of myocarditis and pericarditis after vaccination, especially after the second dose, with symptoms occurring within several days. Quotes displayed in real-time or delayed by at least 15 minutes. Myocarditis. Mayo Clinic on Incontinence - Mayo Clinic Press, NEW The Essential Diabetes Book - Mayo Clinic Press, NEW Ending the Opioid Crisis - Mayo Clinic Press, FREE Mayo Clinic Diet Assessment - Mayo Clinic Press, Mayo Clinic Health Letter - FREE book - Mayo Clinic Press, Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic School of Continuous Professional Development, Mayo Clinic School of Graduate Medical Education, Extracorporeal membrane oxygenation (ECMO), Mayo Clinic Minute: How myocarditis affects men, athletes, Mayo Clinic Q&A podcast: COVID-19 infection and the heart. They note that, based on historical data, among the 544,000 second doses to military members there may have been 0 to 10 expected myocarditis cases, but they observed 19 cases. 11th ed. In more than 192 million people in the U.S. receiving roughly 354 million mRNA-based Covid-19 vaccines between December 2020 and August 2021, 1,626 cases of vaccine-related myocarditis were reported to VAERS, with most occurring in young males. Authors Andrew T Cox 1 , S White 2 , Y Ayalew 2 , C Boos 3 , K Haworth 4 , W J McKenna 5 Affiliations 1 Royal Centre for Defence Medicine, Birmingham, UK St George's, University of London, London, UK. Furthermore, there was a lack of massive cell infiltration or evidence of cardiac necrosis, therefore it was concluded that no myocarditis was present. The vast majority of infections result in mild febrile coryzal or asymptomatic disease, particularly in young patients without comorbidity. Conclusions and relevance: In this case series, myocarditis occurred in previously healthy military patients with similar clinical presentations following receipt of an mRNA COVID-19 vaccine. Market data provided by Factset. The clinical features can be highly variable ranging from an asymptomatic infection to fulminant heart failure. PMC 2022 Jan 25;327(4):331-340. doi: 10.1001/jama.2021.24110. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/myocarditis.html. Myocarditis. Life-threatening myopericarditis can occur but is rare. The clinical and laboratory features of myocarditis are shown in Table 3 and Table S3. Myocarditis is inflammation of the heart muscle (myocardium). Sign up for free, and stay up to date on research advancements, health tips and current health topics, like COVID-19, plus expertise on managing health. Further insights are provided by studies in COVID-19 survivors. Myocarditis Occurring After Immunization With mRNA-Based COVID-19 Vaccines. The DoD has been tracking myocarditis cases throughMarch, according to spokesman Peter Graves. Myocarditis. . Copyright 2023 Military.com. Should any new safety signals be identified by FDA and CDC through this safety surveillance, that information will be communicated to the public," she added. Anti-SARS-CoV-2 vaccine-induced myocarditis - real but, in general, rare and mild: A consensus statement from the Studies Committee of the Portuguese Society of Cardiology. At the time of the publication, cardiac symptoms had resolved for 16 of the patients within a week. Conclusions and Relevance: In this case series, myocarditis occurred in previously healthy military patients with similar clinical presentations following receipt of an mRNA COVID-19 vaccine. Autoimmunity Reviews. On 26 May 2021, the COVID-19 subcommittee of the WHO Global Advisory Committee on Vaccine Safety (GACVS) issued a statement reviewing initial reports of mild myocarditis following COVID-19 mRNA vaccines. sharing sensitive information, make sure youre on a federal [Diagnosis and course of myocarditis: a survey in the medical clinics of Zurich University Hospital 1980 to 1998]. VAERS officials stress that reports of illnesses or health problems following a vaccine do not indicate that the vaccine caused or contributed to the condition, only that an illness occurred in conjunction with receiving a vaccine. Electron microscopy has confirmed presence of viral particles in the myocardium of a critically unwell COVID-19 patient who required ECMO support.7 Furthermore, a case series from Germany reports the detection of SARS-CoV-2 nucleic acid in the myocardium of two patients.8 Of interest, the latter case series labelled their patients as "borderline" myocarditis on the basis of limited myocardial necrosis (the predominant feature was myocardial inflammation). Myocarditis. In the UK Armed Forces, myocarditis results in deaths as well as the premature termination of military careers on medical grounds. Further surveillance and evaluation of this adverse event following immunization is warranted. information and will only use or disclose that information as set forth in our notice of Blood clots had previously been July 3, 2021 This week on A Different Perspective, Dr. Patrick Flynn celebrates Independence Day weekend with a discussion At A Glance: Pfizer, Moderna preparing for boosters to be available as early as this fall. The researchers noted that myocarditis was not reported as an adverse effect in the Phase 3 clinical trials for the mRNA vaccines, and that, other than in the case of the smallpox vaccine, "immunizations are rarely associated with hypersensitivity myocarditis.". All rights reserved. Pfizer did not respond to a request for comment Friday. Symptoms of myocarditis can seem like a heart attack. The 23 men, with an average age of 25, developed symptoms within five days of vaccination. Market data provided by Factset. Myocarditis following immunization with mRNA COVID-19 vaccines in members of the US military. Bookshelf }); or redistributed. Severe myocarditis weakens the heart so that the rest of the body doesn't get enough blood. Myocarditis after BNT162b2 mRNA vaccine against Covid-19 in Israel. They go through rigorous health assessments before they are allowed to enlist or resign their contracts. Furthermore, the degree of pericardial inflammatory response (and therefore size/volume of effusion) does not necessarily correlate with the degree of myocardial involvement, i.e. I also feel like my heart beats hard. Myocarditis can also be caused by HIV, the virus that causes AIDS. All cases were independently adjudicated by at least 2 cardiologists. Accessed March 23, 2022. Cooper LT. The study noted 19 observed myocarditis cases amid 436,000-second doses administered to male military members, which exceeded eight expected cases. Hause AM, et al. Viruses. Troponin is a biomarker that indicates heart damage or a heart attack. Mayo Clinic. More recently, a further case series from Hamburg reports an analysis of cardiac tissue from 39 consecutive autopsies in elderly COVID-19 patients. PMC This site needs JavaScript to work properly. Accessed March 23, 2022. The Food and Drug Administration last week added a warning to the documentation that accompanies the Pfizer and Moderna vaccines to notify recipients of the risk of developing myocarditis, seen mainly in young men. "We applaud Military Health System medical professionals for considering cardiac evaluations. Clipboard, Search History, and several other advanced features are temporarily unavailable. Additionally, overall 20% had a pericardial effusion >1cm.6. The brave men and women in our military fight for our freedoms. 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