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This is VAERS ID 1214410

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History of Changes from the VAERS Wayback Machine

First Appeared on 5/7/2021

VAERS ID: 1214410
VAERS Form:2
Age:27.0
Sex:Female
Location:Nebraska
Vaccinated:2021-04-10
Onset:2021-04-13
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein increased, Chest discomfort, Chest pain, Electrocardiogram normal, Myocarditis, Troponin, Respiratory syncytial virus test negative, Influenza virus test negative, Respiratory viral panel, Magnetic resonance imaging heart, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine loratadine topiramate
Current Illness: between 1st and 2nd covid shots she had dizziness/vertigo for several days which resolved
Preexisting Conditions: hypothyroidism migranes
Allergies: hydrocodone
Diagnostic Lab Data: EKG: NSR With mild nonspecific ST T wave changes troponin peaked at 9.59 on 4/14/21 CRP = 25 on 4/13/21 covid negative 4/14 respiratory pathogen screen negative 4 plex nasal screen, influenza, covid, RSV all negative Cardiac MRI on 4/14/21 report: 1. The left ventricle is normal in cavity size with normal wall thickness, global systolic function is normal with an LVEF at 64%. 2. The right ventricle is normal in cavity size with normal wall thickness, global systolic function is normal with RVEF at 50%. 3. Normal left and right atrium. 4. Delayed contrast enhancement imaging of the left ventricle is abnormal, with evidence of epicardial delayed enhancement in the basal inferolateral wall, with increase in signal in STIR imaging (edema). The prior is most likely consistent with myocarditis. 5. There is no evidence of subendocardial enhancement (myocardial infarction related to coronary artery disease)
CDC 'Split Type':

Write-up: Myocarditis after 2nd covid shot 27 year old female received her 2nd covid shot on 4/10/21 then presented to the hospital with substernal chest pressure upon waking radiating to the left arm on 4/13/21. No previous cardiac history. test shown below, discharged from hospital on 4/15/21. She was improved, no chest pain at time of discharge.


Changed on 5/14/2021

VAERS ID: 1214410 Before After
VAERS Form:2
Age:27.0
Sex:Female
Location:Nebraska
Vaccinated:2021-04-10
Onset:2021-04-13
Submitted:0000-00-00
Entered:2021-04-15
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: C-reactive protein increased, Chest discomfort, Chest pain, Electrocardiogram normal, Myocarditis, Troponin, Respiratory syncytial virus test negative, Influenza virus test negative, Respiratory viral panel, Magnetic resonance imaging heart, SARS-CoV-2 test negative

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 3     Extended hospital stay? No
Previous Vaccinations:
Other Medications: levothyroxine loratadine topiramate
Current Illness: between 1st and 2nd covid shots she had dizziness/vertigo for several days which resolved
Preexisting Conditions: hypothyroidism migranes
Allergies: hydrocodone hydrocodone
Diagnostic Lab Data: EKG: NSR With mild nonspecific ST T wave changes troponin peaked at 9.59 on 4/14/21 CRP = 25 on 4/13/21 covid negative 4/14 respiratory pathogen screen negative 4 plex nasal screen, influenza, covid, RSV all negative Cardiac MRI on 4/14/21 report: 1. The left ventricle is normal in cavity size with normal wall thickness, global systolic function is normal with an LVEF at 64%. 2. The right ventricle is normal in cavity size with normal wall thickness, global systolic function is normal with RVEF at 50%. 3. Normal left and right atrium. 4. Delayed contrast enhancement imaging of the left ventricle is abnormal, with evidence of epicardial delayed enhancement in the basal inferolateral wall, with increase in signal in STIR imaging (edema). The prior is most likely consistent with myocarditis. 5. There is no evidence of subendocardial enhancement (myocardial infarction related to coronary artery disease)
CDC 'Split Type':

Write-up: Myocarditis after 2nd covid shot 27 year old female received her 2nd covid shot on 4/10/21 then presented to the hospital with substernal chest pressure upon waking radiating to the left arm on 4/13/21. No previous cardiac history. test shown below, discharged from hospital on 4/15/21. She was improved, no chest pain at time of discharge.

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