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From the 9/10/2021 release of VAERS data:

This is VAERS ID 1392118



Case Details

VAERS ID: 1392118 (history)  
Form: Version 2.0  
Age: 22.0  
Sex: Female  
Location: Colorado  
Vaccinated:2021-04-15
Onset:2021-06-03
   Days after vaccination:49
Submitted: 0000-00-00
Entered: 2021-06-11
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH ER8727 / 2 RA / IM

Administered by: Private       Purchased by: ?
Symptoms: COVID-19, Cardiac failure congestive, Chest pain, Dyspnoea, Echocardiogram abnormal, Myocardial necrosis marker increased, Pericardial effusion, Pleural effusion, Pleurisy, Pulmonary oedema, Respiratory viral panel, Right ventricular failure, SARS-CoV-2 test positive, Troponin
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Systemic lupus erythematosus (narrow), Myocardial infarction (broad), Acute central respiratory depression (broad), Pulmonary hypertension (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Haemodynamic oedema, effusions and fluid overload (narrow), Cardiomyopathy (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Infective pneumonia (broad), Opportunistic infections (broad), COVID-19 (narrow)

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, ? days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications:
Current Illness:
Preexisting Conditions:
Allergies:
Diagnostic Lab Data: 6/3/21: Initial rapid PCR test for COVID-19 (Abbott ID Now) was negative, subsequent PCR Respiratory Panel detected SARS-CoV-2.
CDC Split Type:

Write-up: After fully vaccinated, patient vacationed and had a negative test prior to return home (end of May). Early June, patient experienced burning chest pain & difficulty breathing. Found to be COVID positive, with elevated cardiac enzymes (troponin 0.45ng/mL). Echocardiogram showed pleural effusion, pleurisy, acute congestive right ventricular heart failure, possible myocarditis vs. severe pulmonary vascular edema, and scant pericardial effusion. Patient was transferred to hospital for higher level of care. Unknown if cardiac effects are related to vaccination or acute disease process.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1392118


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