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From the 11/26/2021 release of VAERS data:

This is VAERS ID 1671372

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Case Details

VAERS ID: 1671372 (history)  
Form: Version 2.0  
Age: 49.0  
Sex: Female  
Location: Utah  
Vaccinated:2021-08-17
Onset:2021-09-02
   Days after vaccination:16
Submitted: 0000-00-00
Entered: 2021-09-03
Vaccin­ation / Manu­facturer Lot / Dose Site / Route
COVID19: COVID19 (COVID19 (JANSSEN)) / JANSSEN 205A21A / 1 AR / IM

Administered by: Private       Purchased by: ?
Symptoms: Chest pain, Magnetic resonance imaging heart, Myocarditis, Troponin increased
SMQs:, 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? No
Office Visit? No
ER Visit? No
ER or Doctor Visit? No
Hospitalized? Yes, 2 days
   Extended hospital stay? No
Previous Vaccinations:
Other Medications: Excedrin migraine, multivitamin with iron
Current Illness: None
Preexisting Conditions: borderline hyperlipidemia; hypertriglyceridemia, hepatic steatosis
Allergies: No known allergies
Diagnostic Lab Data: Elevated troponin level, peak level ng/mL (reference range 0.00 to 0.04ng/mL) on 9/2/21 Cardiac MRI positive for myocarditis 9/3/21
CDC Split Type:

Write-up: Acute myocarditis. Symptoms of chest pain for about 5 days prior to presenting to the hospital


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