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

This is VAERS ID 1460158



Case Details

VAERS ID: 1460158 (history)  
Form: Version 2.0  
Age: 17.0  
Sex: Male  
Location: Maryland  
Vaccinated:2021-06-30
Onset:2021-07-03
   Days after vaccination:3
Submitted: 0000-00-00
Entered: 2021-07-09
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH - / 2 - / IM

Administered by: Unknown       Purchased by: ?
Symptoms: Adenovirus test, Blood thyroid stimulating hormone normal, Blood triglycerides normal, Cardiac imaging procedure abnormal, Chest discomfort, Chest pain, Coxsackie virus test negative, Cytomegalovirus test negative, Echocardiogram, Ejection fraction, Electrocardiogram ST segment elevation, Epstein-Barr virus test negative, Herpes simplex test negative, Magnetic resonance imaging heart, Myocarditis, Prohormone brain natriuretic peptide increased, Thyroxine free normal, Troponin increased
SMQs:, Cardiac failure (broad), Anaphylactic reaction (broad), Myocardial infarction (narrow), Gastrointestinal nonspecific symptoms and therapeutic procedures (broad), Cardiomyopathy (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? No
ER Visit? No
ER or Doctor Visit? Yes
Hospitalized? Yes, 3 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: None
Current Illness: None
Preexisting Conditions: None
Allergies: None
Diagnostic Lab Data: Troponins peaked at 14 . Negative HSV, EBV, Coxsackie, CMV, adenovirus. TSH, free T4, triglycerides wnl. Pro-BNP elevated to 224. Cardiac MRI: IMPRESSION: 1. Subepicardial delayed gadolinium enhancement of the left ventricular inferolateral wall which is characteristic of myocarditis. 2. Normal size and function of the left ventricle. LVEF = 56%.
CDC Split Type:

Write-up: COVID vaccine-associated myocarditis. 3 days after his second Pfizer COVID vaccine, pt presented for chest pain and pressure. Troponin was initially elevated to 4.2, EKG showed ST elevations in lateral leads. Over the course of his stay, troponin dropped, then rose to peak of 14, then dropped again. He was treated with Naproxen 500 mg BID and Pepcid 20 mg BID for gastroprotection. As chest pain resolved, troponins improved, and EKGs improved. Echo and Cardiac MRI were done.


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