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From the 1/14/2022 release of VAERS data:

This is VAERS ID 1371815

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Case Details

VAERS ID: 1371815 (history)  
Form: Version 2.0  
Age: 15.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-21
Onset:2021-05-22
   Days after vaccination:1
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: Abdominal pain upper, Alanine aminotransferase normal, Aspartate aminotransferase normal, Blood creatine phosphokinase increased, Blood creatinine normal, Cardiac imaging procedure abnormal, Chest X-ray normal, Chest pain, Decreased appetite, Echocardiogram abnormal, Electrocardiogram ST segment elevation, Electrocardiogram abnormal, Fibrin D dimer normal, Haemoglobin decreased, Headache, Inflammation, Laboratory test, Left ventricular dysfunction, Lymphocyte count normal, Magnetic resonance imaging heart, Mitral valve incompetence, Mitral valve prolapse, Myocarditis, Neutrophil count normal, Pain, Pericardial effusion, Platelet count normal, Troponin increased, Urine analysis, Urine leukocyte esterase, Vomiting, White blood cell count normal
SMQs:, Rhabdomyolysis/myopathy (broad), Cardiac failure (broad), Acute pancreatitis (broad), Haematopoietic erythropenia (broad), Haemorrhage laboratory terms (broad), Neuroleptic malignant syndrome (broad), Systemic lupus erythematosus (broad), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), 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? No
Recovered? Yes
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: fluoxetine
Current Illness: None
Preexisting Conditions: Marfan syndrome aortic root dilation ADHS
Allergies: None
Diagnostic Lab Data: Labs at Doctor 5/24/2021 WBC of 6.6 Hemoglobin of 12.7 Platelets of 182 Absolute neutrophils of 3.28 Absolute lymphocytes of 2.06 ALT of 12 AST of 23 D-dimer less than 0.19 UA negative for leukocytes, and nitrates Creatinine of 0.62 Troponin of 7.26 Troponin of 11.8 CPK 312. No cultures Radiology results: ECG at Doctor 5/24/2021 Normal sinus rhythm with ST elevation, Chest x-ray at Doctor 5/24/2021 Negative for cardiopulmonary disease. XR Portable Chest 1 View Event Date: 05/24/2021 17:18:26 The cardiothymic silhouette is normal in size and configuration. The lungs are clear. No pleural effusions are identified. A mild dextrocurvature of the thoracic spine is present. CONCLUSION: No evidence of acute cardiopulmonary process. Echocardiogram Complete Congenital Event Date: 05/25/2021 12:54:00 CONCLUSIONS: - Marfan syndrome. Myocarditis s/p COVID-19 immunization. Patent foramen ovale seen previously. Mitral valve prolapse with mild-to-moderate mitral regurgitation. Mildly dilated aortic root. Qualitatively low-normal left ventricular systolic function. New trivial pericardial effusion. 5/26 Cardiac MRI - findings consistent with acute nonischemic inflammation such as that seen in myocarditis
CDC Split Type:

Write-up: 15 year old male with a passed medical history significant for Marfan syndrome, aortic root dilation, and ADHS transferred to our facility for further evaluation and management of chest pain with elevated troponin. Father reports patient recieved the first dose of the COVID-19 Pfizer vaccine on 5/21/2021. On 5/22 patient developed a mild headache as per father that self resolved with rest. On 5/23 as per patient he was feeling back to baseline with some mild body aches. On the night of 5/23 patient felt some mild chest pain prior to going to bed that had self resolved. This morning patient refused to eat breakfast, and complained of stomach pain. Patient took Tylenol, however began to complain of severe chest pain and asked father to take him to the hospital. Patient was taken to his Doctor where his labs were significant for a WBC of 6.6, creatinine of 0.62, normal LFTs, troponin of 7.26, CPK of 312, D-dimer less than 0.19. EKG at Doctor was significant for normal sinus rhythm with an ST elevation, and chest x-ray was negative for cardiopulmonary disease. Patient had an episode of emesis at Doctor. A troponin was repeated prior to transferring to our facility and it had increased to 11.8. Father/patient denies chills, fever, diarrhea, sore throat, nasal congestion, and cough. ID consulted for further recommendations on management of myocarditis in the setting of recent Pfizer COVID-19 vaccination. Troponin repeated upon arrival to our facility, and has improved with no interventions. Interval History 5/27/21 No acute events overnight. Denies chest pain, SOB, cough, or palpitations. Cardiac MRI yesterday describing inflammation related to possible myocarditis, along with stable findings of MVP and aortic root dilation. Troponin this morning dowtrending to 0.28. No fever. He received a Mg Sulfate bolus yesterday due to low Mag on BMP


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