| VAERS ID: |
909635 (history) |
| Form: |
Version 2.0 |
| Age: |
46.0 |
| Sex: |
Male |
| Location: |
Maryland |
| Vaccinated: | 2020-12-21 |
| Onset: | 2020-12-22 |
| Days after vaccination: | 1 |
| Submitted: |
0000-00-00 |
| Entered: |
2020-12-27 |
| Vaccination / Manufacturer |
Lot / Dose |
Site / Route |
| COVID19: COVID19 (COVID19 (PFIZER-BIONTECH)) / PFIZER/BIONTECH |
EK5730 / 1 |
LA / IM |
Administered by: Other Purchased by: ?
Symptoms: Atrial fibrillation,
Cardioversion,
Chest discomfort,
Dyspnoea,
Echocardiogram normal,
Palpitations,
Presyncope
SMQs:, Anaphylactic reaction (broad), Anticholinergic syndrome (broad), Arrhythmia related investigations, signs and symptoms (broad), Supraventricular tachyarrhythmias (narrow), Acute central respiratory depression (broad), Pulmonary hypertension (broad), Cardiomyopathy (broad), Hypotonic-hyporesponsive episode (broad), Hypoglycaemia (broad)
Life Threatening? Yes
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: metformin, Jardiance, Losartan, HCTZ
Current Illness:
Preexisting Conditions: DM, HTN
Allergies: Amoxicillin
Diagnostic Lab Data: Normal echocardiogram
CDC Split Type:
Write-up: Palpitations, shortness of breath, chest tightness, presyncope, which led to New onset atrial fibrillation with rapid ventricular response and required synchronized cardioversion and hospitalization. Discharged on anticoagulation and beta-blocker. |
