VAERS ID: 1374198

AGE: 15| SEX: M|STATE: WA (United States)

Description

Syncope event caused ER trip where abnormal ECG resulted with possible pericarditis

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Symptoms

Syncope, Electrocardiogram abnormal, Full blood count, Metabolic function test, Chest X-ray, Electrocardiogram, Troponin, Blood magnesium

Vaccines

VAX DATE: 05-25-2021| ONSET DATE: 06-02-2021| DAYS TO ONSET: 8
NameDose #TypeManufacturerLotRouteSite
COVID19 (COVID19 (PFIZER-BIONTECH)) 1 COVID19 PFIZER\BIONTECH EW0183 IM RA

RECVDATE:06-04-2021
RPT_DATE:
CAGE_YR:15
CAGE_MO:
DIED:U
DATEDIED:
L_THREAT:U
ER_VISIT:
HOSPITAL:U
HOSPDAYS:
X_STAY:U
DISABLE:U
RECOVD:U
LAB_DATA:6/2/21 ER visit: Blood tests including CBC, metabolic panel, troponin and magnesium; 12 lead ECG (results - borderline LVH, possible acute pericarditis), chest xray
V_ADMINBY:SCH
OTHER_MEDS:Adderall, guanfacine
CUR_ILL:
HISTORY:ADHD
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
TODAYS_DATE:06-04-2021
BIRTH_DEFECT:U
OFC_VISIT:Y
ER_ED_VISIT:Y
ALLERGIES:NKA
V_FUNDBY:

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