chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Abdominal discomfort, Abdominal pain upper, Chills, Cold sweat, Diarrhoea
Clinical narrative: Day 1) sore arm. Day 2) Sorer arm, mild headache, later in day 2, upset stomach, diarrhea,  stayed home from work Day 3) mild to moderate headache, nausea, periods of dizziness, chills, no fever but temp slightly elevated. Day 4) Severe headache, nausea, vomiting, chills, very sleepy, brain fog.  Day 5) moderate to severe headache, still very tired and nauseous, dizziness. Day 6) mild to moderate headache, stomach cramps, nausea, cold sweats, periods of dizziness, brain fog. It has been nearly a week, I still do not feel "right".
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Fatigue, Feeling abnormal, Headache, Nausea
Clinical narrative: Day 1) sore arm. Day 2) Sorer arm, mild headache, later in day 2, upset stomach, diarrhea,  stayed home from work Day 3) mild to moderate headache, nausea, periods of dizziness, chills, no fever but temp slightly elevated. Day 4) Severe headache, nausea, vomiting, chills, very sleepy, brain fog.  Day 5) moderate to severe headache, still very tired and nauseous, dizziness. Day 6) mild to moderate headache, stomach cramps, nausea, cold sweats, periods of dizziness, brain fog. It has been nearly a week, I still do not feel "right".
Age: 52.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity, Somnolence, Vomiting
Clinical narrative: Day 1) sore arm. Day 2) Sorer arm, mild headache, later in day 2, upset stomach, diarrhea,  stayed home from work Day 3) mild to moderate headache, nausea, periods of dizziness, chills, no fever but temp slightly elevated. Day 4) Severe headache, nausea, vomiting, chills, very sleepy, brain fog.  Day 5) moderate to severe headache, still very tired and nauseous, dizziness. Day 6) mild to moderate headache, stomach cramps, nausea, cold sweats, periods of dizziness, brain fog. It has been nearly a week, I still do not feel "right".
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Anxiety, Blood test normal, Dizziness, Dysphagia, Ear discomfort
Clinical narrative: Swollen neck muscles, enlarged lymph nodes under armpits for about a week and a half (may 1-may 14) lump in neck currently- think it?s a lymph node- swallowing a lot w/lots of saliva , headaches, dizziness, tired a lot, weird flashes over my body, legs feeling warm sometimes then goes, ran a small fever in the beggin. Of may - 99.4, nausea, popping behind ears when I swallow currently, anxious
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Feeling abnormal, Headache, Lymphadenopathy, Nausea
Clinical narrative: Swollen neck muscles, enlarged lymph nodes under armpits for about a week and a half (may 1-may 14) lump in neck currently- think it?s a lymph node- swallowing a lot w/lots of saliva , headaches, dizziness, tired a lot, weird flashes over my body, legs feeling warm sometimes then goes, ran a small fever in the beggin. Of may - 99.4, nausea, popping behind ears when I swallow currently, anxious
Age: 26.0
Sex: M
Vaccine: COVID19
Symptoms: Pyrexia, Skin warm, Swelling
Clinical narrative: Swollen neck muscles, enlarged lymph nodes under armpits for about a week and a half (may 1-may 14) lump in neck currently- think it?s a lymph node- swallowing a lot w/lots of saliva , headaches, dizziness, tired a lot, weird flashes over my body, legs feeling warm sometimes then goes, ran a small fever in the beggin. Of may - 99.4, nausea, popping behind ears when I swallow currently, anxious
Age: 48.0
Sex: M
Vaccine: COVID19
Symptoms: Back pain, Pyrexia
Clinical narrative: backache began 5/10/2021 at 6:30pm and lasted 24 hours fever of 102 degrees / pyrexia began 5/10/2021 at 7:30pm and lasted 24 hours oscillopsia occurred on 5/17/2021 at 4pm and lasted 5 minutes
Age: 21.0
Sex: M
Vaccine: COVID19
Symptoms: Hypotension, Syncope
Clinical narrative: Approximately 5-10 minutes after vaccine was given patient stayed in store but shopped around and passed out in the aisle while shopping. He quickly came to and did not hurt himself in the fall. EMS was called and arrived. They evaluated the patient and the patient's blood pressure was low. They administered an IV and took the patient and not to a healthcare facility.
Age: 66.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Pain in extremity, Peripheral swelling
Clinical narrative: Symptoms started a week later. Severe pain in the right shoulder. In the morning cannot lift my right arm up to the side of my body. Lifting it forward showed no signs of pain. Then during the day and night, pain in both knees and ankles needing to hold the banister to walk up or down 1 step at a time.  Also developed swelling and in my lower legs. Bought special circulation knee high socks. Also pain in both feet. Went to the doctor and they prescribed medication I chose not to take. Opted for Tylenol 650 mg. I am not one to take medications, especially when they cannot determine the root causes. Dr. prescribed an ultrasound, right shoulder and also legs for circulation issues that I did not have before. I walk a lot in my job and do many physical tasks with no fatigue of pain before the vaccination. Am overweight but healthy and strong. I was a competitive bodybuilder in my late 20's and early 30's. I do my own gardening, mowing, mulching and planting etc and throughly enjoy it with no fatigue or pain at all before the vaccination. Now I can barely make it through an hour of activity without pain. Normally I have always had a high threshold for pain and heal fast. However this new set of conditions have me perplexed. I did some research on the vaccine and now I understand why I am all of a sudden having these issues. "Joint and Muscle Pain" The issue is, why is it lasting this long? It has been over a month since my second dose of the Vaccine. As a note ... I had a fall at work in March where I injured my right hand, no fractures were noted in x-rays. Just a bone/muscle bruise in the thenar region. I went through physical therapy and after 3 weeks it healed. My 1st vaccine dose was March 9, 2021 and I chose to have the vaccine administered in my left arm. 800 Mg of Ibuprofen was given but stopped taking it by the time I had my first vaccine. No other complaints until after my 2nd dose in April. At first I attributed the joint pains to the fall, however, the time line does not correspond, since these new pains started after April 6 (my first vaccine dose.
Age: 46.0
Sex: F
Vaccine: COVID19
Symptoms: Herpes zoster, Pain, Rash
Clinical narrative: Shingles diagnosed on May 17, 2021.  Pain and rash started on Monday, May, 10, 2021.  Rash followed on May 12.
Age: 55.0
Sex: M
Vaccine: COVID19
Symptoms: Bell's palsy
Clinical narrative: Bell's palsy started 5-6 days after dose #2 of Pfizer COVID vaccine.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Asthenia, Dizziness, Fatigue, Headache, Hyperaesthesia
Clinical narrative: About 2 hours after shot, I passed out. Became very weak, dizzy and eventually passed out.  After being alerted, I slept the rest of the day.  Friday night, did not sleep well and sweated profusely, never detected fever.  Extreme fatigue and profuse sweating for 3 days.  Saturday, same, extreme fatigue, profuse sweating, headache, dizziness.  Saturday night, nausea, sweating, no rest.  Sunday morning, woke late, feeling totally exhausted still, bed, clothing, hair were soaked from sweating all night.  Have had all over muscle ache/pain. Skin sensitive to the touch--muscle soreness.  Took a long time to be able to wake up fully--then more fatigue, sweating.  Later Sunday afternoon, the symptoms primarily started easing.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Hyperhidrosis, Insomnia, Loss of consciousness, Myalgia, Nausea
Clinical narrative: About 2 hours after shot, I passed out. Became very weak, dizzy and eventually passed out.  After being alerted, I slept the rest of the day.  Friday night, did not sleep well and sweated profusely, never detected fever.  Extreme fatigue and profuse sweating for 3 days.  Saturday, same, extreme fatigue, profuse sweating, headache, dizziness.  Saturday night, nausea, sweating, no rest.  Sunday morning, woke late, feeling totally exhausted still, bed, clothing, hair were soaked from sweating all night.  Have had all over muscle ache/pain. Skin sensitive to the touch--muscle soreness.  Took a long time to be able to wake up fully--then more fatigue, sweating.  Later Sunday afternoon, the symptoms primarily started easing.
Age: 62.0
Sex: F
Vaccine: COVID19
Symptoms: Pain, Somnolence
Clinical narrative: About 2 hours after shot, I passed out. Became very weak, dizzy and eventually passed out.  After being alerted, I slept the rest of the day.  Friday night, did not sleep well and sweated profusely, never detected fever.  Extreme fatigue and profuse sweating for 3 days.  Saturday, same, extreme fatigue, profuse sweating, headache, dizziness.  Saturday night, nausea, sweating, no rest.  Sunday morning, woke late, feeling totally exhausted still, bed, clothing, hair were soaked from sweating all night.  Have had all over muscle ache/pain. Skin sensitive to the touch--muscle soreness.  Took a long time to be able to wake up fully--then more fatigue, sweating.  Later Sunday afternoon, the symptoms primarily started easing.
Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: Interchange of vaccine products
Clinical narrative: pt received Janssen Covid Vaccine on 5/13/21. Discovered in system that pt received 1st dose Moderna from a Walmart Pharmacy on 4/24/21
Age: 18.0
Sex: F
Vaccine: COVID19
Symptoms: Dysmenorrhoea, Heavy menstrual bleeding, Menstruation irregular
Clinical narrative: My daughter had finished her normal menstrual period on  4/6/21 (which is barely a period due to being on The Pill).  On 4/19 while playing soccer she started to bleed acutely and profusely.  She experienced severe cramping all event as well.  This entire episode lasted for approximately 3 days.  We immediately called her OBGYN. Who specifically asked if she had gotten the Covid vaccine.  When I responded yes, it was communicated that this type of incident was happening a lot.
Age: 39.0
Sex: F
Vaccine: COVID19
Symptoms: Pain in extremity
Clinical narrative: After 2nd shot, arm was very sore for a few days but it has been 3 weeks and my left upper arm still aches all day. No redness or swelling present.
Age: 35.0
Sex: F
Vaccine: COVID19
Symptoms: Exposure during pregnancy, High risk pregnancy, Premature separation of placenta
Clinical narrative: I am currently pregnant, I be 31 weeks tomorrow. The adverse event occurred on 27 weeks, 6 days, had a marginal placenta abruption, was in Hospital for 5-6 days for monitoring.  So far baby and I are doing okay.  EDD: high risk pregnancy, not specified.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Discomfort, Headache, Injection site swelling, Nausea, Rash macular
Clinical narrative: Extreme swelling at vaccine site, red spot - after 10 days, still some swelling Nausea, headache, general discomfort (felt like I was hit by a truck) - about 5 days, lessening each day  Treatment with acetaminophen
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Alopecia, Chills, Cyst, Head discomfort, Headache
Clinical narrative: Chills, fever, headache, couldn't feel legs after second dose  8 weeks later: hair falling out, cysts on liver and kidney, cyst on scalp  10 weeks later: large bruising over injection site.
Age: 73.0
Sex: F
Vaccine: COVID19
Symptoms: Hepatic cyst, Hypoaesthesia, Injection site bruising, Pyrexia, Renal cyst
Clinical narrative: Chills, fever, headache, couldn't feel legs after second dose  8 weeks later: hair falling out, cysts on liver and kidney, cyst on scalp  10 weeks later: large bruising over injection site.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Chest X-ray normal, Computerised tomogram head, Computerised tomogram neck, Disorganised speech, Electrocardiogram normal
Clinical narrative: At approximately 5:20pm on 5/10/21 I started having jumbled speech. I would be speaking clearly and then random words would take the place of the words I was trying to say. I was unable to use the correct words my brain was telling myself to say. Then I started experiencing tingling sensation throughout my right arm. Believing that I could be having a stroke my wife rushed me to the emergency room at hospital. En route to the ER, my left arm began to have tingling sensation in it as well. Once at the ER I began hyperventilating. I was in the ER for approximately 4-5 hours, for 3 of those hours I had difficulty communicating and could not speak clearly. I was told I may have been having a complex migraine and was discharged and referred to a neurologist. I met with the neurologist and given that I have no history of headaches or migraines, they concluded that it most likely was not a complex migraine and discussed the possibility of an immune response. It has now been a week since my ER visit, since then I have been getting extremely fatigued every afternoon and my head feels spacey.
Age: 33.0
Sex: M
Vaccine: COVID19
Symptoms: Fatigue, Feeling abnormal, Hyperventilation, Magnetic resonance imaging head normal, Paraesthesia
Clinical narrative: At approximately 5:20pm on 5/10/21 I started having jumbled speech. I would be speaking clearly and then random words would take the place of the words I was trying to say. I was unable to use the correct words my brain was telling myself to say. Then I started experiencing tingling sensation throughout my right arm. Believing that I could be having a stroke my wife rushed me to the emergency room at hospital. En route to the ER, my left arm began to have tingling sensation in it as well. Once at the ER I began hyperventilating. I was in the ER for approximately 4-5 hours, for 3 of those hours I had difficulty communicating and could not speak clearly. I was told I may have been having a complex migraine and was discharged and referred to a neurologist. I met with the neurologist and given that I have no history of headaches or migraines, they concluded that it most likely was not a complex migraine and discussed the possibility of an immune response. It has now been a week since my ER visit, since then I have been getting extremely fatigued every afternoon and my head feels spacey.
Age: 16.0
Sex: M
Vaccine: COVID19
Symptoms: Immediate post-injection reaction, Syncope
Clinical narrative: Patient had syncopal episode with in 60 seconds of vaccination. Patient responded immediately to nurse when name was called. Patient was helped  down to the  floor vital signs taken BP low O2 sat 95%. Ambulance crew was in the parking lot of College came in to assess patient, FNP came from clinic at College to assess patient. Continuous monitoring of vital signs, patient BP came up, patient given orange juice to drink per FNP. Patient was very anxious about vaccination and had eaten since the previous day. Patient monitored about 45 minutes, vital signs improved, patient appearance improved and stated he felt better. Patient 's Mother reached on phone by ambulance crew, she did not want him transported. Patient left College accompanied by brother. Advised to be seen by provider or ER if symptoms worsen.
Age: 59.0
Sex: M
Vaccine: COVID19
Symptoms: Disturbance in attention, Headache, Pain in extremity, Somnolence
Clinical narrative: 4 DAYS IN A ROW:  NEARLY CONTINUOUS HEADACHE, EXTREME SLEEPINESS (RESULTING IN 1 HOUR "ANP").  FOR 2 DAYS:  AT TIMES DIFFICULTY FOCUSING.  7 DAYS: SORE LEFT ARM.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Dizziness, Hyperhidrosis, Loss of consciousness, Nausea, Pallor
Clinical narrative: Patient received in RN triage area, post-COVID vaccination administration. Patient being observed for 15 minutes as recommended per CDC guidelines on post-vaccination RN monitoring. Patient approached nurses stating that she felt nauseous and lightheaded. Patient noted diaphoretic, and pale in color; while helping patient to the wheelchair the patient fainted and was completed unconscious. Patient guided to floor by staff. Patient was unconscious for about a minute while on floor. RRT called. When patient came to patient reporting lightheadedness, blurred vision. Vitals 09:11: BP: 103/62, HR: 63, O2: 96%. Patient denies any history of syncope or fainting. Patient stated that she had not had anything to eat this morning.  Denies any Hx of anaphylactic reaction to vaccines.  Patient denies adverse reactions to vaccinations in past. Tolerated injection well. Patient sent to ER with RRT . All questions and concerns addressed.
Age: 38.0
Sex: F
Vaccine: COVID19
Symptoms: Syncope, Vision blurred
Clinical narrative: Patient received in RN triage area, post-COVID vaccination administration. Patient being observed for 15 minutes as recommended per CDC guidelines on post-vaccination RN monitoring. Patient approached nurses stating that she felt nauseous and lightheaded. Patient noted diaphoretic, and pale in color; while helping patient to the wheelchair the patient fainted and was completed unconscious. Patient guided to floor by staff. Patient was unconscious for about a minute while on floor. RRT called. When patient came to patient reporting lightheadedness, blurred vision. Vitals 09:11: BP: 103/62, HR: 63, O2: 96%. Patient denies any history of syncope or fainting. Patient stated that she had not had anything to eat this morning.  Denies any Hx of anaphylactic reaction to vaccines.  Patient denies adverse reactions to vaccinations in past. Tolerated injection well. Patient sent to ER with RRT . All questions and concerns addressed.
Age: 34.0
Sex: F
Vaccine: COVID19
Symptoms: Epistaxis, Pyrexia
Clinical narrative: Starting 48 hours after vaccination, patient developed 30 hours of fevers greater than 100.3 and blood nose ~15 hours
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Arthralgia, Chest discomfort, Chills, Dyspnoea, Headache
Clinical narrative: Chills, fever, huge headaches, muscle pain, joints pain, difficult in breathing, heavy chest,  nausea, frequent urinations,  random pinching sensation on my arms.
Age: 27.0
Sex: F
Vaccine: COVID19
Symptoms: Limb discomfort, Myalgia, Nausea, Pollakiuria, Pyrexia
Clinical narrative: Chills, fever, huge headaches, muscle pain, joints pain, difficult in breathing, heavy chest,  nausea, frequent urinations,  random pinching sensation on my arms.
Age: 65.0
Sex: M
Vaccine: COVID19
Symptoms: Arthralgia
Clinical narrative: shoulder joint pain since date of injection on march 1, 2021. Pain for over two months
Age: 52.0
Sex: M
Vaccine: COVID19
Symptoms: Herpes zoster
Clinical narrative: Diagnosed with shingles.
Age: 57.0
Sex: F
Vaccine: COVID19
Symptoms: Dyspnoea, Headache, Pulmonary pain, X-ray
Clinical narrative: Trigger asthma symptoms; headaches - I noticed headaches the next day; On Wednesday I had a really bad one all day. The headache kept going until I went to ER (sent me there said they couldn't treat me at Urgent Care) on Friday when my breathing was getting very compromised - pain in my right lung on Thursday and Friday and It felt like I had a really bad bronchial infection. Before I went to ER - I was using my inhaler all the time - 4-6 times a day (14th, 15th, 16th and the first half following the ER visit.) No other treatment - they said just follow up with Primary care or Pulmonologist.  After my ER visit, I used my inhaler for the first half of the week and then it started getting better and also the environment was having less pollen and so that was improving as well.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Alanine aminotransferase increased, Arthralgia, Aspartate aminotransferase increased, Blood albumin normal, Blood alkaline phosphatase normal
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood bilirubin normal, Blood calcium increased, Blood chloride normal, Blood creatinine increased, Blood glucose normal
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood potassium normal, Blood sodium normal, Blood test, Blood urea normal, C-reactive protein increased
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Carbon dioxide normal, Cardiac monitoring normal, Chest X-ray normal, Chest pain, Chills
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Cytomegalovirus test negative, Dyspnoea, Echocardiogram normal, Electrocardiogram ST segment elevation, Epstein-Barr virus antibody positive
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Haematocrit normal, Haemoglobin normal, Inflammation, Magnetic resonance imaging normal, Myocarditis
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: N-terminal prohormone brain natriuretic peptide increased, Pain, Painful respiration, Platelet count decreased, Protein total normal
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Red blood cell count decreased, Red blood cell sedimentation rate increased, SARS-CoV-2 test negative, Tachycardia, Troponin increased
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.
Age: 17.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: White blood cell count increased
Clinical narrative: 17 y.o. male who presents with chest pain, elevated troponins and diffuse ST elevations concerning for pericarditis vs myocarditis admitted for cardiac monitoring and evaluation. Pt states he has had 1 day of sudden onset L shoulder pain and chest pain. Endorses dyspnea due to pain with deep breaths, denies tachypnea, nausea/vomiting, diaphoresis. Endorses mild chills and aches after COVID vaccine 3 days prior to onset of symptoms, denies any fever, URI symptoms, diarrhea, rash, known COVID contacts. Pain continued to worsen and spread across his chest, causing presentation to ED this afternoon. No history of PE, DVT, long travel, recent surgery, malignancy, alcohol or cocaine use. Significant cardiac history in family: dad with CAD w/LAD blockage, both parents with hypertension.    At ED, labs notable for elevated troponin 0.456, repeat 0.67 and diffuse ST elevations on EKG concerning for pericarditis. COVID neg, CXR unremarkable, blood cx drawn, no abx started. Patient was given toradol for pain with minimal improvement. Peds cardiology was consulted and patient was transferred to different ED for further care.   At different ED, repeat EKG showed similar diffuse ST elevations in I, II, aVL. Repeat troponins uptrending (4.91), proBNP 562, ESR 43, CRP 18. Mildly tachycardic but otherwise hemodynamically stable. Given tylenol for pain. Cardiology recommended admission for trending troponins, echo and cardiac monitoring.  CV: Troponins were trended every 12 hours with a max of 4.91.  His last troponin checked on the morning of discharge was 0.41.  He had an echo that showed normal cardiac function, an MRI that indicated normal ventricular size and function, with minimal or healing and inflammation or mild myocarditis.  During his admission, he had continuous cardiorespiratory monitoring, that did not show any arrhythmias.   Resp: On 2L NC for comfort, no respiratory distress or hypoxia.   FENGI: Regular diet   Neuro: Ibuprofen scheduled and tylenol PRN for pain.  He was initially started on ibuprofen 800 mg every 8 hours, but was starting to have pain prior to being due for medicine every 8 hours so his regimen was changed to 600 mg every 6 hours which controlled his pain adequately.   ID: Myocarditis panel sent with some results still pending.  Thus far, he is CMV negative, EBV IgG was positive but not IgM.  RVP was negative.  This all occurred in the setting receiving the Covid vaccine 3 days prior to presentation, which has been reported as a rare reaction to the Covid vaccine.  At the time of discharge, labs pending results include mycoplasma pneumonia, coxsackie, parvovirus, enterovirus. Etiology of myocarditis remains unclear at this time, could be related to infectious etiology not yet clear to us, vs related to his COVID vaccine prior to admission.