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This is VAERS ID 279109

Case Details

VAERS ID: 279109 (history)  
Form: Version 1.0  
Age: 20.0  
Gender: Female  
Location: Arizona  
Submitted: 2007-05-17
Entered: 2007-05-21
   Days after submission:4
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
HPV4: HPV (GARDASIL) / MERCK & CO. INC. - / 3 - / IM

Administered by: Private       Purchased by: Private
Symptoms: Cardiac electrophysiologic study normal, Chest pain, Constipation, Dizziness, Electrocardiogram abnormal, Electrocardiogram normal, Electroencephalogram, Headache, Insomnia, Palpitations, Syncope, Tilt table test, Vision blurred
SMQs:, Torsade de pointes/QT prolongation (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Glaucoma (broad), Cardiomyopathy (broad), Lens disorders (broad), Retinal disorders (broad), Vestibular disorders (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? Yes
ER or Doctor Visit? No
Hospitalized? Yes, 10 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Yasmin
Current Illness: None
Preexisting Conditions: records received 6/20/07-One year history of significant recurrent arrhythmia with heart pounding especially when laying flat or bending forward.
Diagnostic Lab Data: EEG, EPS negative, EKG positive, ECG negative, tilt table positive, ARS negative records received 6/20/07-Normal 2D ec ehocardiogram.Normal EEG. CT head normal. s 1/1/10 follow up - syncope, fast heart rate, headaches, fatigue,weak immune system, dizziness, lightheadness; due to the syncope episodes my cardiologist implanted a pacemaker and still being treated for postural orthostatic tachycardia syndrome brought on from vaccine.
CDC Split Type:

Write-up: Dizziness, syncope, headaches, blurred vision, constipation, insomnia, racing heart, chest pain 12/06 to present. Treatment: Florinef, Midrodone, Mestinon 6/7/07-records received from facility for DOS 5/10-5/15/07-Impression:orthostatic intolerance. EEG, somewhat disorganized occipital dominant rhythm. CT head unremarkable. CBC WNL. Echocardiogram normal. Tilt table test with electrophysiologic study no orthostatic hypotension with head-up tile but a prominent tachycardia. Apparent stimulation of A-V nodal pathway showed no evidence of an A-V nodal re-entrant tachycarida. HX of recurrent syncope. Onset of occasional chest pain and a fleeting sensation of palpitations. Without any other symptoms until January of this year. C/O being dizzy a lot. PE WNL except for some palmar hyperhidrosis. 6/20/07-record received fro DOS 1/9-5/29/07. One year history of significant recurrent arrhythmia with heart pounding especially when laying flat or bending forward. No syncope during exercise. Possible mitral valve prolapse. DC DX: from 1/9-1/11/07-Orthostatic paroxysmal tachycardia. DC DX for DOS 3/15-3/20/07-Postural orthostatic tachycardia syndrome. Recurrent syncope. Orthostatic hypotension.

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