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From the 11/12/2021 release of VAERS data:

This is VAERS ID 1371640

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Case Details

VAERS ID: 1371640 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-05
Onset:2021-05-09
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / -

Administered by: Unknown       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Blood creatine phosphokinase increased, C-reactive protein normal, Chest X-ray normal, Chest discomfort, Chest pain, Cough, Echocardiogram normal, Electrocardiogram abnormal, Full blood count normal, Metabolic function test normal, Myocarditis, Myoglobin blood increased, SARS-CoV-2 test negative, Sinus arrhythmia, Sinus bradycardia, Streptococcus test, Streptococcus test negative, Troponin I increased
SMQs:, Rhabdomyolysis/myopathy (narrow), Anaphylactic reaction (broad), Neuroleptic malignant syndrome (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad), COVID-19 (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: vitiligo
Allergies: None
Diagnostic Lab Data: 5/9 - Total CK (317), CPK-MB (13), troponin I (3.34), and myoglobin (168) were done and elevated. Repeat troponin I 2 hours later was higher at 4.85. EKG revealed sinus bradycardia and sinus arrhythmia. Chest x-ray was done and unremarkable. Echo final read was normal.
CDC Split Type:

Write-up: 17-year-old male with past medical history of vitiligo presenting with chest pain in the setting of acute myocarditis. Patient refers history of pressure-like chest pain which started suddenly on the morning of presentation, retrosternal, nonradiating, 4/10, with no exacerbating factors, relieved with a p.o. dose of metamizole, which prompted a visit to Hospital. He developed a dry cough in route to the hospital. At the hospital, CBC, BMP, and CRP were done and unremarkable. U tox, SARS-CoV-2 PCR, and rapid strep were done and unremarkable. Total CK (317), CPK-MB (13), troponin I (3.34), and myoglobin (168) were done and elevated. Repeat troponin I 2 hours later was higher at 4.85. EKG revealed sinus bradycardia and sinus arrhythmia. Chest x-ray was done and unremarkable.


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