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From the 9/17/2021 release of VAERS data:

This is VAERS ID 1437376



Case Details

VAERS ID: 1437376 (history)  
Form: Version 2.0  
Age: 19.0  
Sex: Male  
Location: Pennsylvania  
Vaccinated:2021-06-25
Onset:2021-06-29
   Days after vaccination:4
Submitted: 0000-00-00
Entered: 2021-06-30
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / UNK - / -

Administered by: Private       Purchased by: ?
Symptoms: Blood creatine phosphokinase MB increased, Chest X-ray normal, Chest discomfort, Chest pain, Echocardiogram, Ejection fraction decreased, Electrocardiogram abnormal, Fatigue, Myocarditis, Nausea, Pain, Pain in extremity, Palpitations, Sensory disturbance, Sinus arrhythmia, Sinus bradycardia, Sleep disorder, Troponin increased, Ventricular hypokinesia, Vomiting
SMQs:, Cardiac failure (narrow), Anaphylactic reaction (broad), Acute pancreatitis (broad), Peripheral neuropathy (narrow), Myocardial infarction (narrow), Arrhythmia related investigations, signs and symptoms (broad), Disorders of sinus node function (narrow), Guillain-Barre syndrome (broad), Noninfectious encephalitis (broad), Gastrointestinal nonspecific symptoms and therapeutic procedures (narrow), Cardiomyopathy (narrow), Tendinopathies and ligament disorders (broad), Drug reaction with eosinophilia and systemic symptoms syndrome (broad), Immune-mediated/autoimmune disorders (broad)

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? Yes
Office Visit? Yes
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Buspar
Current Illness: Anxiety and depression
Preexisting Conditions:
Allergies: Amoxicillin, Cephalexin
Diagnostic Lab Data: 6/29 - EKG showed sinus bradycardia with rate of 53 and sinus arrhythmia. Chest x-ray was clear. Troponin elevated at 10.7. Cardiology was consulted in the ED and ordered a TTE which showed decrease LVEF of 40%, mild left ventricular global hypokinesis, which is suggestive of myocarditis. Troponin was trended and continued to rise up to 19.5. CK-MB and CK were both elevated.
CDC Split Type:

Write-up: Patient is a 19 y.o. male with PMH significant for anxiety and ADHD who presents with chest pain and palpitations. He was woken up this morning by chest pain described as sharp, midsternal, 7/10, radiating down right arm, with no exacerbating or alleviating factors. He also reports chest pressure. During episode of chest pain he felt his heart was beating fast. He felt nauseous and vomited once. He received his 2nd Pfizer COVID vaccine 4 days ago. He states that he felt fatigue and aching for a day following the vaccine.


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