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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1464677

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Case Details

VAERS ID: 1464677 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: New York  
   Days after vaccination:0
Submitted: 0000-00-00
Entered: 2021-07-12
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: Private       Purchased by: ?
Symptoms: Back pain, Blood calcium normal, Blood magnesium normal, Blood phosphorus normal, Chest pain, Chills, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment elevation, Electrocardiogram repolarisation abnormality, Full blood count abnormal, Influenza like illness, Intensive care, Leukocytosis, Metabolic function test normal, Myocarditis, Nausea, Oropharyngeal pain, Pain in extremity, Pyrexia, Troponin increased, Vomiting
SMQs:, Torsade de pointes/QT prolongation (broad), Anaphylactic reaction (broad), Acute pancreatitis (broad), Haematopoietic leukopenia (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (narrow), Conduction defects (narrow), Retroperitoneal fibrosis (broad), Oropharyngeal conditions (excl neoplasms, infections and allergies) (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (narrow), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 1 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Whey Protein
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: PT is a 17 y/o previously healthy boy who presented with 3 days of moderate-severe, substernal chest pain, dyspnea, and nausea 2 days after receiving the 2nd dose of the Pfizer COVID-19 vaccine found to have elevated troponins at 3.36 and ST elevation, probably early repolarization on EKG consistent with perimyocarditis. 7/11 Cardiac ECHO showed "Normal biventricular systolic function. No pericardial effusion." He was initially admitted to the PICU. His initial CBC showed a mild leukocytosis with normal BMP, Ca, Mg, and Phos. Troponins were trended q8h and were downtrending (1.59 <- 2.91 <- 3.36) at the time of discharge. - He remained asymptomatic and hemodynamically stable throughout his entire admission and his physical exam at the time of discharge was significant for "Regular rate and rhythm; normal S1/S2. No murmurs, rubs, or gallops. Capillary refill <2 seconds. 2+ Radial pulses. No tibial edema present."
CDC Split Type:

Write-up: PT is a 17 y/o previously healthy boy who presents with 3 days of moderate-severe, substernal chest pain, dyspnea, and nausea 2 days after receiving the 2nd dose of the Pfizer COVID-19 vaccine. On Tuesday (7/6), PT received the second Pfizer COVID-19 vaccine. The following day (Wednesday 7/7) PT had "flu-like symptoms" with chills, subjective fever, and a sore arm that resolved by Thursday (7/8). He was back to his baseline state of health on Thursday (7/8) and felt fine that whole day. On Friday afternoon (7/9) when he was at work washing dishes where he had some physical exertion he began to notice at 16:30-17:00 that he developed substernal, sharp, 7/10 chest pain that did not radiate, improve/worsen with deep breaths, sitting up, laying down or with movement of his upper extremities. It worsened towards the end of the night and peaked at 8/10 by 22:00-23:00 that same evening. His sister picked him up from work per his regular routine and he went home and took a shower which improved the pain to a 5-6/10 when he went to sleep. He woke up at 3 AM on Saturday (7/10) AM and had one episode of NBNB emesis associated with the chest pain. When he woke up later that morning he felt improved until 10-12 AM he developed mild chest pain again which he took Tums for. He also tried Motrin which did not help his pain at all. On the morning of admission (7/11), he woke up at 6-7 AM with upper right back pain, dyspnea, and nausea along with the persistent chest pain which prompted him to present to MFSH. He does endorse mild sore throat but denies any fevers, recent sick contacts, known COVID-19 exposure or previous history of COVID-19. There is a family history of cardiac disease including a fatal MI in his father. His mother''s family also has a history of heart disease and both sides have a history of high cholesterol. He did add Whey Protein recently to his diet to for muscle building, but he DENIES any drug, alcohol, tobacco, vaping, marijuana, THC use. He does not play any sports regularly. He also denies any recent bug/tick bites or rashes.

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