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This is VAERS ID 1220590

History of Changes from the VAERS Wayback Machine

First Appeared on 5/14/2021

VAERS ID: 1220590
VAERS Form:2
Age:45.0
Sex:Male
Location:California
Vaccinated:2021-04-13
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-1 / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Acute myocardial infarction, Blood creatinine increased, Catheterisation cardiac abnormal, Chest pain, Chest X-ray abnormal, Chills, Coronary artery occlusion, Diarrhoea, Dyspnoea, Echocardiogram, Nausea, Pain in extremity, Pallor, Peripheral coldness, Pulmonary oedema, Respiratory failure, Restlessness, Vomiting, Ejection fraction, Ejection fraction decreased, Acute coronary syndrome, Coronary arterial stent insertion, Intra-aortic balloon placement, Echocardiogram abnormal, Percutaneous coronary intervention, Endotracheal intubation

Life Threatening? Yes
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: albuterol, fluticasone, cetirizine, pioglitazone, lisinopril, glipizide
Current Illness:
Preexisting Conditions: DM2, HTN, HLD, obesity
Allergies: metformin (GI symptoms)
Diagnostic Lab Data: 4/15 CXR with pulmonary edema 4/15 Transthoracic echocardiogram with LVEF < 25%, apical mural thrombus 4/15 Cr 1.95 increased from baseline Cr 1.20 on 2/27/21 4/16 Heart cath with 100% occluded LAD
CDC 'Split Type':

Write-up: - In the early morning of 4/14/21 Pt called Kaiser help line complaining of cold hands/ feet, restlessness, pallor, R arm pain. - Telephone visit 4/14/21 complained of chills, nausea, vomiting, abdominal cramping, diarrhea. Fluids and rest recommended. - 4/15/21 presented to Kaiser with chest pain, shortness of breath, abdominal pain. Diagnosed with late presentation of acute coronary syndrome / anterior ST elevation MI. Echo with low EF < 25%, LV apical thrombus - 4/16/21 heart catheterization showed 100% occlusion of LAD treated with PCI / DES x 2, IABP. Endotracheal intubation for respiratory failure.


Changed on 7/16/2021

VAERS ID: 1220590 Before After
VAERS Form:2
Age:45.0
Sex:Male
Location:California
Vaccinated:2021-04-13
Onset:2021-04-14
Submitted:0000-00-00
Entered:2021-04-16
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH 59267-1000-1 / 2 RA / IM

Administered by: Private      Purchased by: ??
Symptoms: Abdominal pain, Acute myocardial infarction, Blood creatinine increased, Catheterisation cardiac abnormal, Chest pain, Chest X-ray abnormal, Chills, Coronary artery occlusion, Diarrhoea, Dyspnoea, Echocardiogram, Nausea, Pain in extremity, Pallor, Peripheral coldness, Pulmonary oedema, Respiratory failure, Restlessness, Vomiting, Ejection fraction, Ejection fraction decreased, Acute coronary syndrome, Coronary arterial stent insertion, Intra-aortic balloon placement, Echocardiogram abnormal, Percutaneous coronary intervention, Endotracheal intubation

Life Threatening? Yes
Birth Defect? No
Died? No Yes
   Date died:0000-00-00 2021-05-12
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: albuterol, fluticasone, cetirizine, pioglitazone, lisinopril, glipizide
Current Illness:
Preexisting Conditions: DM2, HTN, HLD, obesity
Allergies: metformin (GI symptoms)
Diagnostic Lab Data: 4/15 CXR with pulmonary edema 4/15 Transthoracic echocardiogram with LVEF < 25%, apical mural thrombus 4/15 Cr 1.95 increased from baseline Cr 1.20 on 2/27/21 4/16 Heart cath with 100% occluded LAD
CDC 'Split Type':

Write-up: - In the early morning of 4/14/21 Pt called Kaiser help line complaining of cold hands/ feet, restlessness, pallor, R arm pain. - Telephone visit 4/14/21 complained of chills, nausea, vomiting, abdominal cramping, diarrhea. Fluids and rest recommended. - 4/15/21 presented to Kaiser with chest pain, shortness of breath, abdominal pain. Diagnosed with late presentation of acute coronary syndrome / anterior ST elevation MI. Echo with low EF < 25%, LV apical thrombus - 4/16/21 heart catheterization showed 100% occlusion of LAD treated with PCI / DES x 2, IABP. Endotracheal intubation for respiratory failure.

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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1220590&WAYBACKHISTORY=ON

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