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This is VAERS ID 1105352

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History of Changes from the VAERS Wayback Machine

First Appeared on 4/16/2021

VAERS ID: 1105352
VAERS Form:2
Age:52.0
Sex:Female
Location:New York
Vaccinated:2021-03-11
Onset:2021-03-14
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arteriogram carotid normal, Arthralgia, Chest pain, Dyspnoea, Electrocardiogram abnormal, Electrocardiogram QT prolonged, Electrocardiogram T wave inversion, Neck pain, Pain, Pericarditis, Electrocardiogram T wave abnormal, Troponin

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: omeprazole, Synthroid, venlafaxine, vitamin
Current Illness: none
Preexisting Conditions: gastroparesis, hoshimoto hypothyroidism, epilepsy
Allergies: Tree fruits
Diagnostic Lab Data: Troponin 3/14/21 @1445 was 0.255, @ 2008 was 0.218 and 3/15/21 at 0002 was 0.159 EKG - 3/14/21 - low voltage qrs and t wave abnormality EKG - 3/15/21 - prolonged QT interval or TU fusion, Diffuse T Wave Inversions anterior and lateral leads ? Ischemia Cardiologist diagnosed her with pericarditis
CDC 'Split Type':

Write-up: Patient woke with severe chest pain and difficult to take deep breaths. Chest pain extended over her shoulder and around her neck. Pain worsened during the day, went to ER, found to have positive troponins and subsequent ecg were abnormal. Echo was negative and angiogram showed no blocked arteries. Cardiologist diagnosed her with pericarditis


Changed on 5/7/2021

VAERS ID: 1105352 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:New York
Vaccinated:2021-03-11
Onset:2021-03-14
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arteriogram carotid normal, Arthralgia, Chest pain, Dyspnoea, Electrocardiogram abnormal, Electrocardiogram QT prolonged, Electrocardiogram T wave inversion, Neck pain, Pain, Pericarditis, Electrocardiogram T wave abnormal, Troponin

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: omeprazole, Synthroid, venlafaxine, vitamin
Current Illness: none
Preexisting Conditions: gastroparesis, hoshimoto hypothyroidism, epilepsy
Allergies: Tree fruits fruits
Diagnostic Lab Data: Troponin 3/14/21 @1445 was 0.255, @ 2008 was 0.218 and 3/15/21 at 0002 was 0.159 EKG - 3/14/21 - low voltage qrs and t wave abnormality EKG - 3/15/21 - prolonged QT interval or TU fusion, Diffuse T Wave Inversions anterior and lateral leads ? Ischemia Cardiologist diagnosed her with pericarditis
CDC 'Split Type':

Write-up: Patient woke with severe chest pain and difficult to take deep breaths. Chest pain extended over her shoulder and around her neck. Pain worsened during the day, went to ER, found to have positive troponins and subsequent ecg were abnormal. Echo was negative and angiogram showed no blocked arteries. Cardiologist diagnosed her with pericarditis


Changed on 5/14/2021

VAERS ID: 1105352 Before After
VAERS Form:2
Age:52.0
Sex:Female
Location:New York
Vaccinated:2021-03-11
Onset:2021-03-14
Submitted:0000-00-00
Entered:2021-03-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EN6203 / 2 LA / IM

Administered by: Private      Purchased by: ??
Symptoms: Arteriogram carotid normal, Arthralgia, Chest pain, Dyspnoea, Electrocardiogram abnormal, Electrocardiogram QT prolonged, Electrocardiogram T wave inversion, Neck pain, Pain, Pericarditis, Electrocardiogram T wave abnormal, Troponin

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: omeprazole, Synthroid, venlafaxine, vitamin
Current Illness: none
Preexisting Conditions: gastroparesis, hoshimoto hypothyroidism, epilepsy
Allergies: Tree fruits fruits
Diagnostic Lab Data: Troponin 3/14/21 @1445 was 0.255, @ 2008 was 0.218 and 3/15/21 at 0002 was 0.159 EKG - 3/14/21 - low voltage qrs and t wave abnormality EKG - 3/15/21 - prolonged QT interval or TU fusion, Diffuse T Wave Inversions anterior and lateral leads ? Ischemia Cardiologist diagnosed her with pericarditis
CDC 'Split Type':

Write-up: Patient woke with severe chest pain and difficult to take deep breaths. Chest pain extended over her shoulder and around her neck. Pain worsened during the day, went to ER, found to have positive troponins and subsequent ecg were abnormal. Echo was negative and angiogram showed no blocked arteries. Cardiologist diagnosed her with pericarditis

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