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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1350646

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Case Details

VAERS ID: 1350646 (history)  
Form: Version 2.0  
Age: 37.0  
Sex: Female  
Location: North Carolina  
   Days after vaccination:18
Submitted: 0000-00-00
Entered: 2021-05-26
Vaccin­ation / Manu­facturer Lot / Dose Site / Route

Administered by: School       Purchased by: ?
Symptoms: Asthenia, Cardiac failure, Catheterisation cardiac, Computerised tomogram, Dyspnoea, Fatigue, Fluid retention, Magnetic resonance imaging, Myocarditis, Peripheral swelling
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Angioedema (broad), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Guillain-Barre syndrome (broad), Extravasation events (injections, infusions and implants) (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? Yes
Recovered? No
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 12 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Adderall XR 30mg
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 05/07 emergency room visit. MRI catscans. Heart catherization. Admission in hospital from 05/07 -05/19 Heart failure - heart transplant needed
CDC Split Type:

Write-up: Jannsen covid-19 vaccine EUA Shortness of breath. Leg swelling. Myocarditis, fluid retention, fatigue, weakness. Heart failure symptoms

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