Age: 26.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Magnetic resonance imaging spinal normal, Malaise, Muscle twitching, Nerve compression, Neutrophil count increased
Clinical narrative: 1/25/21 - numbness and tingling, feeling of nerve tension began in right arm  and hand with no clear peripheral nerve pattern; next day in both arms with twitching of R middle finger; third day afternoon began in R foot and spread up into calf as well as L foot; went to the ER on 1/27/21; clear ECG, chest XR, brain and cervical CT, and bloodwork; referred to neurologist with concerns of MS or transverse myelitis;  saw neurologist on 2/3/21 - he found mildly hyperactive reflexes and a (+) hoffman's reflex; ordered MRI of brain and cervical spine with and without contrast and more bloodwork; MRIs performed apx 1 1/2 weeks later and bloodwork done same day (2/3); bloodwork revealed elevated C-reactive protein of ~14 and ESR of 14 (higher than previous baseline of <2) but all else clear; MRIs came back clear 2/8/21 - 9 days after second dose woke up with throbbing headache, body aches, and overall feeling of being ill; on the third day of this went to go get tested for COVID and flu to be safe; both rapid and PCR came back negative; sx resolved by the weekend;  2/15/21 - began getting frequent headaches, inability to take a deep breath and sharp retrosternal chest pain up into the back of my throat when I would try; difficulty breathing with a mask on; significantly elevated heart rate; SOB at work esp with mask on; symptoms worse with mask and then eased on weekends without mask; then became able to take deep breath but with chest pain then began to need to cough with a deep breath then more frequent coughing esp after long days of mask wearing; several occasions of waking up at night unable to breath esp when lying on either side with racing heart; symptoms vary in intensity but on days when they would act up, heart rate is consistently elevated (normal resting heart rate ~55, would be up at 90 while lying down, 120 while standing making coffee) 3/9/21 - went to ER in the evening due to symptom increase of chest pain, SOB, and elevated heart rate; ER ran bloodwork and found elevated D-dimer of 0.6, WBC of 27,000, high neutrophils, and low lymphocytes; CT angiogram to r/o PE came back negative; (-) chest XR other than minor atelectasis; abnormal ECG with incomplete RBBB and prolonged QT interval; tachycardia; admitted to hospital; blood cultures, urine cultures, and respiratory pathogen panel including COVID test negative; started on albuterol breathing treatments and 40 mg of steroids 2x/day which normalized WBC count and eased sx significantly; consult with pulmonology and cardiology; 2nd chest x-ray (-) and transthoracic ECHO (-); started on beta blockers 12.5 mg 2x/day which helped heart rate some; second ECG found no RBBB and normal QT interval but unable to rule out anterior MI or inferior ischemia. D/c on steroid dose pack, beta blockers, cough suppressant. Follow up with cardio and pulm. Now seeing immunologist as well who started me on corticosteroid inhaler, monteleukast. Running more blood work soon. PCP gave albuterol inhaler, did round of antibiotics, orders to use incentive spirometer for breathing capacity. Waiting on pulmonology follow up and 30 day holter monitor, stress ecg, and other cardiac tests.