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This is VAERS ID 1371767

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First Appeared on 6/11/2021

VAERS ID: 1371767
VAERS Form:2
Age:17.0
Sex:Male
Location:Florida
Vaccinated:2021-05-14
Onset:2021-05-19
Submitted:0000-00-00
Entered:2021-06-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Unknown      Purchased by: ??
Symptoms: Blood creatine phosphokinase increased, Blood creatine phosphokinase MB increased, C-reactive protein increased, Chest pain, Chest X-ray normal, Condition aggravated, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Full blood count normal, HIV test negative, Myocarditis, Nausea, Ventricular extrasystoles, Ventricular tachycardia, Vomiting, Red blood cell sedimentation rate normal, Cytomegalovirus test negative, Cardiac telemetry abnormal, Cardiac imaging procedure abnormal, Troponin I increased, Antinuclear antibody positive, Echocardiogram abnormal, Myocardial oedema, Respiratory viral panel, Mycoplasma test negative, 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: 5     Extended hospital stay? No
Previous Vaccinations:
Other Medications: Bactrim and Keflex
Current Illness: abscess on right groin
Preexisting Conditions: hypercholesterolemia 2014 - myocarditis
Allergies: None
Diagnostic Lab Data: 5/19 - Patient''s troponin at outside was 34.5. CK-MB was 41.6. CK was 523, x-ray that showed no acute process, EKG at outside hospital shows sinus rhythm with occasional PVC. Mild diffuse settle ST elevation and no PR depression. Echo: Very poor echocardiographic windows. No significant valvar dysfunction. Qualitatively normal biventricular systolic function. No significant pericardial effusion 5/21 - Patient''s troponin has been up trending from 6.07-8.92. Repeat troponin at 10 AM this morning was 5.03. RPP at outside hospital negative. CMV negative. Mycoplasma negative. HIV negative. Follow up ECHO: Acute myopericarditis. Cardiac MRI: 1. Late gadolinium enhancement pattern and edema on T2 STIR images are consistent with acute myocarditis (and other nonischemic cardiomyopathies). 2. Normal biventricular size and systolic function. 3. No significant pericardial effusion. 5/22 - troponin 2.93 Patient was found to have positive TPOG, SS-A and Sm ab
CDC 'Split Type':

Write-up: Patient began with substernal chest pain 8 out of 10. Patient was taken to emergency room. At the outside hospital patient was given Motrin with improvement of pain. Patient''s troponin at outside was 34.5. CK-MB was 41.6. CK was 523. CBC was unremarkable. Sed rate was 15. CRP 1.46. Patient had chest x-ray that showed no acute process. EKG at outside hospital shows sinus rhythm with occasional PVC. Mild diffuse settle ST elevation and no PR depression. Upon arrival to the floor patient had no significant pain. On telemetry patient was found to have an episode of nonsustained ventricular tachycardia. Patient denies recent cough, congestion or fevers. Patient does have 2 parents and a dog at home. Of note patient got first dose of pfizer Sars-Covid-19 vaccine on April 14. Second dose of Pfizer vaccine was given on May 14. Initial troponin i-STAT presentation was 11.03. Patient also experiencing nausea and vomiting on 5/20.

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