VAERS ID: 1334612

AGE: 16| SEX: M|STATE: WA (United States)

Description

Chest pain, fever, headache and fatigue starting morning after vaccination. Progression of chest pain prompting evaluation in the emergency room where he was found to have a Troponin of 23,000 (nl less then 50). D'Dimer mildly elevated. ST changes on EKG. CTA negative. LFT mildly elevated. Sent to hospital where admitted to cardiology service pm 5/19 and given a diagnosis of myocarditis. Still under care at this time of report.

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Symptoms

Pyrexia, Lymphadenopathy, Headache, Red blood cell sedimentation rate increased, Alanine aminotransferase increased, Aspartate aminotransferase increased, Chest pain, Myocarditis, Fatigue, C-reactive protein increased, Computerised tomogram abnormal, Troponin increased, Angiogram normal, Fibrin D dimer increased, Electrocardiogram ST-T change, Respiratory viral panel, Liver function test increased, SARS-CoV-2 test negative, SARS-CoV-2 antibody test

Vaccines

VAX DATE: 05-15-2021| ONSET DATE: 05-16-2021| DAYS TO ONSET: 1
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 2 COVID19 PFIZER\BIONTECH ew-0182 IM LA

RECVDATE:05-20-2021
RPT_DATE:
CAGE_YR:16
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:Y
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:EKG- Ste elevation (v1+v3, possible R ventricle hypertrophy CT scan- enlarged R axillary lymphnodes ALT/AST 102/241. (5/19) Troponin 23,642 ->19.4->15.28->13.41->11.18-> 10.72 (am 5/20) 5/19: CRP 11.3 (nl), D dimer 1.19, ESR 15, COVID AB (spike protein IgG): POS, COVID PCR NEG. Viral respiratory panel NEGATIVE> infectious workup otherwise pending (adeno, entero, CMV, EBV, bartonella, Parvo, HHV6) Nucleocapsid COVID antibody pending
V_ADMINBY:PHM
OTHER_MEDS:ibuprofen
CUR_ILL:none
HISTORY:in utero diagnosis of agenesis of corpus callosum- asymptomatic, no meds, no seizures
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:05-20-2021
BIRTH_DEFECT:U
OFC_VISIT:U
ER_ED_VISIT:U
ALLERGIES:none
V_FUNDBY:

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