Conclusion
The case we encountered is extremely rare in four respects: ACS occurred
immediately after vaccination, the collected thrombus was evaluated
pathologically, it showed large vasa vasorum, and the unknown aetiology
of COVID-19 vaccine-related ACS was partly clarified. Careful
observation after vaccination is necessary for those at high risk of
cardiovascular diseases, and intravascular imaging and pathological
examination of the thrombus are effective for evaluating coronary
lesions and clarifying the pathogenesis of ACS.