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This is VAERS ID 1379530

History of Changes from the VAERS Wayback Machine

First Appeared on 6/11/2021

VAERS ID: 1379530
VAERS Form:2
Age:23.0
Sex:Male
Location:Pennsylvania
Vaccinated:2021-06-02
Onset:2021-06-04
Submitted:0000-00-00
Entered:2021-06-07
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA - / UNK - / -

Administered by: Pharmacy      Purchased by: ??
Symptoms: Asthenia, Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram abnormal, Electrocardiogram ST segment elevation, Fatigue, Headache, Hyperhidrosis, Pyrexia, Ventricular tachycardia, Cardiac imaging procedure abnormal, Troponin increased, Myocardial oedema

Life Threatening? No
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: Not applicable
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: 6/1/2021, EKG showed diffuse ST elevations. Echo done was normal . Troponin was intially 4.63 and trended up to 18.80. Cardiac MRI was done 6/5/21 which revealed edema.
CDC 'Split Type':

Write-up: Patient started having generalized weakness, fatigue, fever and headache after the second dose of his Moderna Covid-19 vaccine. These symptoms persisted throughout the next day. However, two days after the second Covid-19 shot patient developed severe chest pain that resulted in presentation in the ED. There was associated shortness of breath and diaphoresis. He was treated with Colchicine and Ibuprofen. He was also started on metoprolol because he had an 11-beat run of non-sustained ventricular tachycardia. He was discharged home on the fourth day to follow up with cardiology as outpatient.

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