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This is VAERS ID 1490649

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First Appeared on 7/23/2021

VAERS ID: 1490649
VAERS Form:2
Age:42.0
Sex:Male
Location:Iowa
Vaccinated:2021-06-29
Onset:2021-07-13
Submitted:0000-00-00
Entered:2021-07-21
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 207A21A / N/A - / IM

Administered by: Private      Purchased by: ??
Symptoms: Blood creatine phosphokinase increased, Chest discomfort, Chest pain, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment elevation, Pain, Pericarditis, White blood cell count normal, Troponin I, Haemodynamic test normal, Ejection fraction normal

Life Threatening? No
Birth Defect? No
Died? No
Permanent Disability? No
Recovered? No
Office Visit (V2.0)? No
ER or Office Visit (V1.0)? No
ER or ED Visit (V2.0)? No
Hospitalized? Yes, days: 2     Extended hospital stay? No
Previous Vaccinations:
Other Medications: baclofen 10mg bid carbamazepine 200mg TID citalopram 40mg daily fluticasone nasal spray bid PRN Allergy eye drops, PRN daily
Current Illness:
Preexisting Conditions: Epilepsy
Allergies: aspirin
Diagnostic Lab Data: 7/18: CK total 281, troponin I high sens <3, WBC 6.4, Afebrile, stable vitals with HR 70s-80s, RR 35-18, BP 121/58 ECG diffuse ST elevation and P wave depression
CDC 'Split Type':

Write-up: Diagnosed with pericarditis Presented to the emergency department on 7/18/2021 with chest pain (substernal) and does not radiate, but reports heaviness and pressure. The pain was severe at onset. This is exacerbated by exercise but are relieved by nitroglycerine and fentanyl. Family history of CAD. Also reports shortness of breath. Pain onset was abrupt while riding his bicycle. ECG shows diffuse ST selevation in multiple coronary distributions with P depression. Bedside ECHO showed normal heart. EF was ~60%. Hemodynamically stable. Given one dose of Toradol., SL nitro 0.4mg Admitted to the hospital Started on colchicine 0.6mg bid and ibuprofen 600mg tid with plan of 10 days of treatment.

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