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This is VAERS ID 1371704

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History of Changes from the VAERS Wayback Machine

First Appeared on 6/18/2021

VAERS ID: 1371704
VAERS Form:2
Age:16.0
Sex:Male
Location:Florida
Vaccinated:2021-05-15
Onset:2021-05-18
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 LA / -

Administered by: Unknown      Purchased by: ??
Symptoms: Arthralgia, Chest discomfort, Chest pain, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Intensive care, Myocarditis, Pain, Sleep disorder, Cardiac imaging procedure abnormal, Troponin increased, Myocardial oedema, Mycoplasma test positive, Mycoplasma test negative, Electrocardiogram PR segment depression, Magnetic resonance imaging heart

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? Yes
Hospitalized? Yes, days: 4     Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 5/18 - EKG with diffuse PR depression and ST elevation. Troponin elevated at 4.5. 5/19 - Mycoplasma IGM + but PCR neg 5/21 - Cardiac MRI - Late gadolinium enhancement pattern and edema on T2 STIR images are consistent with acute myocarditis (and other nonischemic cardiomyopathies). Normal biventricular size and systolic function. Pericardial inflammation without significant effusion.
CDC 'Split Type':

Write-up: 16-year-old male with no significant past medical history, now presenting with chest pain. Patient had 2 episodes of left-sided mid-chest pain. The initial episode was at ~ 3 am on 5/18 when the pain woke him up from sleep, lasted for ~ 20 minutes and he was able to fall back to sleep, he did not mention it to his parents at that time. Then it recurred at 2.30 pm - pressure-like pain in the same area, which radiated to his left shoulder. There were no significant worsening or alleviating factors. No change in pain quality or intensity with position. No shortness of breath, near-syncope or syncope, no palpitations. Upon his second pain episode, he called his parents on video chat and they instructed him to take 81 mg of aspirin and the pain subsided after 30 minutes. His parents promptly took him to the urgent care where he was found to have ST elevation and elevated troponin. He was transferred to CICU for further management. Admitted for myopericarditis with ST elevation and elevated troponin. On motrin q8h ATC, 12 lead EKG and troponin levels q6h. Underwent cardiac MRI on 5/20 which confirmed the diagnosis.

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