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Write-up: THROWING UP BLOOD; FEELING LIKE BEING CHOKED; HEAVY FEELING IN CHEST; FELT SHAKY; FELT SICK; STROKE-LIKE SYMPTOMS; PAIN IN BASE OF SPINE; LEFT TORSO AND BOTH ARMS ITCHING; DEHYDRATION; This spontaneous report received from a patient concerned a 58 year old female. Initial information was processed along with additional information on 04-JUN-2021. The patient''s height, and weight were not reported. The patient''s past medical history included vertebral dissection of right vertebral artery in 2000, hiatal hernia, chemotherapy, radiation, vertebral tear, 5 years of cancer drugs and stroke-like symptoms, and concurrent conditions included 2 times breast cancer survivor, non-smoker, and sulfa drug allergy cause night time swells in mouth and tongue. The patient experienced pain in base of spine when treated with pegfilgrastim for breast cancer. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 042A21A expiry: UNKNOWN) dose was not reported, 1 in total administered at left arm on 09-APR-2021 for prophylactic vaccination. Concomitant medications included acetylsalicylic acid, and pravastatin. On an unspecified date in 2021, the patient had elevated lactate level of 2.5 (unit unspecified) and was 1.5 (unit unspecified) on repeat and also had elevated chloride level was 110 (unit unspecified). The patient was dehydrated. On 09-APR-2021, the patient had left torso and both arms itching for 4 hours, started within half hour after received vaccine. On 10-APR-2021, the patient experienced pain in base of spine, which was exactly the same as when she received Neulasta during a previous cancer treatment regimen and patient experienced headache for 3 days. On 21-APR-2021, the patient woke up with left side numbness from head to toes, feeling like being choked as if like an allergy, felt heaviness in chest, within one hour patient felt shaky and like she was going to faint, felt dizziness/lightheaded and laid down for 2 days, later felt like her eyes were going to pop out of her head, was putting Refresh eye drops in her eyes and was having problems focusing her eyes (vision disturbances). The patient was only able to stay up for 2 hours, then had lie down because felt sick and weakness and had sever fatigue. All like stroke-like symptoms. The symptoms started on 21-APR-2021. The patient went to emergency room on 24-APR-2021 and discharged on same day. On 28-APR-2021, the patient had computed tomography scan and showed occluded right Vertebral artery. The patient had a computed tomography scan one year ago and there was no occlusion. They did a computed tomography scan that showed a same occlusion as on 28-APR-2021. On 28-APR-2021, the patient had stenosis of right carotid artery. The patient went back to emergency room on 15-MAY-2021 because she was throwing up blood and dizzy and she was told to go to emergency room. On 11-JUN-2021, she was going to see a stroke neurologist specialist a neurosurgeon 16-JUN-2021. On 15-MAY-2021, the patient went to emergency room and they re-performed a computed tomography scan and it showed an occluded right vertebral artery just as first scan did. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from left torso and both arms itching on 09-APR-2021, had not recovered from pain in base of spine, and stroke-like symptoms, and the outcome of heavy feeling in chest, feeling like being choked, felt shaky, felt sick, dehydration and throwing up blood was not reported. This report was serious (Other Medically Important Condition).; Sender''s Comments: V0: This spontaneous report received from a patient concerned a 58-year-old female who experienced stroke-like symptoms and occluded vertebral artery 15 days after vaccine. Past medical history included vertebral dissection of right vertebral artery in 2000, hiatal hernia, chemotherapy, radiation, vertebral tear, 5 years of cancer drugs and stroke-like symptoms, and concurrent conditions included 2 times breast cancer survivor. Concomitant medications included acetylsalicylic acid, and pravastatin. On day 12 after vaccine, the patient woke up with left side stroke-like symptoms. The patient went to emergency room on day 15 and discharged on same day. On day 19, the patient had computed tomography scan and showed occluded right Vertebral artery. The patient had a computed tomography scan one year ago and there was no occlusion. She was discharged and evaluated by stroke neurologist. There is no report of thrombocytopenia to suggest thrombosis with thrombocytopenia syndrome. Given the pre-existing history of vertebral artery dissection, there is a plausible alternative explanation for the event.
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