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

This is VAERS ID 1242167



Case Details

VAERS ID: 1242167 (history)  
Form: Version 2.0  
Age: 21.0  
Sex: Male  
Location: New York  
Vaccinated:2021-04-16
Onset:2021-04-19
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-04-22
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 UN / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Chest pain, Echocardiogram, Electrocardiogram, Fatigue, Magnetic resonance imaging heart, Myalgia, Myocarditis, Troponin
SMQs:, Rhabdomyolysis/myopathy (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Eosinophilic pneumonia (broad), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: N/A
Diagnostic Lab Data: Troponin I - 9, Echocardiogram was normal, EKG showing diffuse ST elevations, cardiac MRI showing late gadolinium enhancement consistent with myocarditis.
CDC Split Type:

Write-up: Shortly after second dose, patient experienced myalgias, fatigue, but 3 days later, developed chest pain with troponin elevations and was found on MRI to have myopericarditis. He is otherwise stable, He is being treated with antiinflammatories with good response


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1242167

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