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From the 10/15/2021 release of VAERS data:

This is VAERS ID 1212280

Case Details

VAERS ID: 1212280 (history)  
Form: Version 2.0  
Age: 69.0  
Sex: Female  
Location: Tennessee  
   Days after vaccination:20
Submitted: 0000-00-00
Entered: 2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 1805025 / 1 RA / IM

Administered by: Other       Purchased by: ?
Symptoms: Chest pain
SMQs:, Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? No
Previous Vaccinations:
Other Medications: Routine daily meds- Aspirin, Avastatin, Nitro patch, Naproxin, "pain killers"-unsure name
Current Illness:
Preexisting Conditions: History of heart disease with a heart attack in 2014 with stent She has had 5 other stents since then. Last being on 12/01/2020. History of 3 back surgeries.
Allergies: Oxycodone
Diagnostic Lab Data:
CDC Split Type:

Write-up: Complaints of chest pain. She went to ER. She was sent home and said no heart attack. She then had another episode of chest pain on 04/11/21 and went to ER and was sent home and told to see cardiologist.

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