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

This is VAERS ID 1430571



Case Details

VAERS ID: 1430571 (history)  
Form: Version 2.0  
Age: 45.0  
Sex: Male  
Location: Florida  
Vaccinated:2021-05-27
Onset:2021-06-04
   Days after vaccination:8
Submitted: 0000-00-00
Entered: 2021-06-28
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (MODERNA)) / MODERNA 001T21A / 2 LA / -

Administered by: Pharmacy       Purchased by: ?
Symptoms: Chest pain, Dizziness, Electrocardiogram, Intensive care, Stent placement
SMQs:, Anticholinergic syndrome (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (broad), Vestibular disorders (broad)

Life Threatening? Yes
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 4 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: N/A
Current Illness: N/A
Preexisting Conditions: N/A
Allergies: Penicillin
Diagnostic Lab Data: EKG
CDC Split Type:

Write-up: Having a slight pain in chest didn''t thing anything of it , it went away until a few days later on June 4th the pain didn''t go, went into the bathroom and almost passed out go the ambulance rushed to the hospital where they had to put a stint in the leg and stayed 4 days in the ICU before being able to come home. Has to take medicine everyday now for heart.


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https://medalerts.org/vaersdb/findfield.php?IDNUMBER=1430571


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