Age: 54.0
Sex: M
Vaccine: ANTH, FLUX, HEP, HEPA, MEN, SMALL, YF, FLUX, MEN, SMALL, YF, ANTH, FLUX, HEP, HEPA, MEN, SMALL, YF, ANTH, FLUX, HEP, HEPA, MEN, SMALL, YF
Symptoms: Chest pain, Dyspepsia, Dyspnoea, Laboratory test abnormal, Myocardial infarction
Clinical narrative: Information has been received from a health authority and a health professional concerning a 54 year old male with hyperlipidemia, degenerative joint disease of both ankles, osteoarthritis, a history of migraines (now resolved), and left shoulder surgery.  The pt denies any past history of hypertension, angina, CHF, CVA, valvular heart disease, diabetes, asthma, cancer or thyroid disease.  The pt reported that he "sometimes" became short of breath after exercise, but that this was baseline for him.  On 02/02/2003 the pt was vaccinated SC with a first dose of AVA (batch FAV073).  On 02/15/03 the pt was vaccinated IM with a first dose of Hep A (inactive)(Lot # 644168/0980M)(manufacturer unknown), a first dose given intramuscularly of hepatitis B virus vaccine, a first dose given SC of yellow fever virus vaccine (YF-VAX)(Batch # UB358AA), a second dose given ID in the left arm of SP vaccine (Dryvax)(Batch #4020071), a first dose given SC of meningococcal ACYW polysaccharide vaccine (Menomune)(Batch #UB269AA), a third dose given IM of influenza virus vaccine (unspecified), and a second dose given SC in the left arm of AVA vaccine (Biothrax). Concomitant therapy included ramipril (Altace) 2.5mg per mouth daily, aspirin 325 mg per mouth daily, isosorbide mononitrate (Imdur) 30mg per mouth daily, atorvastatin calcium (Lipitor) 10 mg per mouth daily, metoprolol tartrate (Lopressor) 25mg per mouth daily, and clopidogrel bisulfate (Plavix) 75mg per mouth daily.  On 03/05/2003 the pt was vaccinated SC with a third dose of ANA (Biothrax).  On 09/22/03 a radiologic examination revealed the lungs to be mildly hyperinflated but clear of infiltrate.  The heart and pulmonary vessels appeared to be normal size.  The impression was a non-specific hyperinflation and focal degenerative changes of the left distal clavicle of the AC joint  On 10/02/03 the pt recalled feeling heartburn while resting which he described as a "strong urge to burp", but he was unable to do so.  It was reported that the pt described the sensation as a burning feeling in the middle of his chest and rated it as a 6 out of 10 on a pain scale.  On 10/03/03 the pt was seen in the ER where he was diagnosed with a MI.  The pt's medical records noted that he had experienced intermittent chest pain/pressure at rest for two to three weeks.  He had elevated cardicac enzymes, an initial EKG with ST elevation in Lead III, and subsequent T wave inversion in leads II, III and catherterization with stent placement.  Mild posterior wall hypokinesis was revealed.  The left heart catherization and left ventriculogram and coronary angiogram revealed severe two-vessel coronary artery disease with the right coronary artery being the "culprit" of the pt's recent non Q MI.  The left anterior descending artery was of very small caliber.  It was not optimal for surgical intervention.  Ther was normal left ventricular systolic function.  Gated spect images of the heart were obtained after the pts recovery, which revealed the left ventricular ejection fraction is calculated to be 66% and wall motion is good.  The impression from the Cardiolite Scan was an abnormal perfusion study with ischemia in the inferolateral wall region.  The pt was discharged from the hospital and since his discharge he has denied any further chest pain or "heartburn" type symptoms.  The pt was schedule for another stress test on 11/15/03.  His recovery status is currently unknown.  It was also noted that the pt stated that he was concerned that the vaccinations he had received may have contributed to his cardiac problems. MI was considered to be immediately life-threatening and an other important medical event (OMIC).  Other business partner numbers include E200303322 & 212869.  No further information is available.