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This is VAERS ID 1290102

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/4/2021

VAERS ID: 1290102
VAERS Form:2
Age:35.0
Sex:Male
Location:Colorado
Vaccinated:2021-04-29
Onset:2021-05-02
Submitted:0000-00-00
Entered:2021-05-05
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH EW0173 / 1 LA / IM

Administered by: Other      Purchased by: ??
Symptoms: Acute myocardial infarction, Angiogram pulmonary normal, Blood iron decreased, Blood thyroid stimulating hormone normal, Chest pain, Chest X-ray normal, Echocardiogram, Electrocardiogram abnormal, Full blood count normal, Hypoaesthesia, Lipids decreased, Lymphadenopathy, Myocarditis, Nausea, Paraesthesia, Pericardial effusion, Vomiting, Red blood cell sedimentation rate normal, Transferrin saturation decreased, Brain natriuretic peptide normal, Cardiac imaging procedure abnormal, Troponin I increased, Right ventricular ejection fraction decreased, Magnetic resonance imaging heart, SARS-CoV-2 test negative

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)? Yes
Hospitalized? Yes, days:     Extended hospital stay? No
Previous Vaccinations:
Other Medications: men''s multivitamin, "acid suppression"
Current Illness: none reported
Preexisting Conditions: hypertension- never treated with medication
Allergies: yeast, gluten
Diagnostic Lab Data: In the ED: CBC, TSH, BNP, and electrolytes: within normal ranges Troponin I: 1.21, 2.81 ng/mL High-sensitivity troponin I: 3443.8 ng/L SARS-CoV-2 RNA: negative ECG: Sinus rhythm, borderline left axis deviation Chest x-ray: no acute cardiopulmonary process On admission: Iron: 33 ug/dL Iron % saturation: 11% ESR: 11 mm/hr CRP: mg/L Lipid panel: HDL 33 mg/dL, rest within normal ranges TTE: grossly preserved LV function, no wall abnormalities CTA chest: No acute pulmonary embolism, left axillary adenopathy could be related to recent COVID vaccination Cardiac MR: Findings consistent with punctate focal myocarditis although cannot exclude an embolic light etiology; normal left ventricular size and systolic function, LVEF 62%; normal right ventricular size and systolic function, RVEF 52% ; evidence of pericardial effusion.
CDC 'Split Type':

Write-up: Pfizer-BioNTech COVID-19 Vaccine EUA: three days after vaccination patient presents to emergency department (ED) reporting sudden onset severe chest pain, emesis, numbness/tingling of arms, and nausea. Initial vital signs: pulse = 90 beats per minute, blood pressure 142/100 mmHg, oxygen saturation 95% on room air. Patient admitted for management of NSTEMI: differential includes myocarditis.

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