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VAERS ID: 1000418

AGE: 47| SEX: M|State: PR

Description

Pleuritic chest pain. Admitted due to acute pericariditis. Course complicated with new onset atrial fibrillation.

Symptoms

Atrial fibrillation, Pleural effusion, Chest X-ray abnormal, Pleuritic pain, Chest X-ray normal, Echocardiogram normal, Pericarditis

Vaccines

VAX DATE: 14 December 2020 | ONSET DATE: 03 January 2021 | DAYS TO ONSET: 20
Vaccine TypeManufacturerVaccine NameDoseRouteSiteLot
  • COVID19
  • PFIZERBIONTECH
  • COVID19 (COVID19 (PFIZER-BIONTECH))
  • UNK
  • SC
  • LA
  • EH9899
  • EK5730

RECVDATE:
03 February 2021
CAGE_YR:
47
CAGE_MO:
RPT_DATE:
DIED:
DATEDIED:
L_THREAT:
Y
ER_VISIT:
HOSPITAL:
Y
HOSPDAYS:
5
X_STAY:
DISABLE:
RECOVD:
Y
LAB_DATA:
TEE: Normal 2DEcho: Normal CXR: Left pleural effusion
V_ADMINBY:
PVT
OTHER_MEDS:
None
CUR_ILL:
None
HISTORY:
None
PRIOR_VAX:
SPLTTYPE:
FORM_VERS:
2
TODAYS_DATE:
03 February 2021
BIRTH_DEFECT:
OFC_VISIT:
ER_ED_VISIT:
ALLERGIES:
Acetaminophen Aspirin Dextromethorphan Shellfish
V_FUNDBY:
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