Age: 65.0
Sex: F
Vaccine: COVID19
Symptoms: Cough, Dizziness, Dyspnoea, Dyspnoea exertional, Dyspnoea paroxysmal nocturnal
Clinical narrative: chest pain/ aching; squeezing sensation; cannot take a deep breath/difficulty breathing; her oxygen levels had dropped; chest tightness; dyspnea on exertion; chills; Irregular heartbeat; pains all over her body; Occasional dizziness; knee swelling; systolic blood pressure increased 142/80; Dry cough; palpitations; Paroxysmal noctural dyspnea; fatigue; malaise; generalized weakness; This is a spontaneous report received from contactable reporter(s) (Physician).  A 65 year-old female patient (not pregnant) received bnt162b2 (BNT162B2), administration date 31Jul2021 (Batch/Lot number: unknown) at the age of 65 years as dose 1, single for covid-19 immunisation. Relevant medical history included: "Alcohol use" (unspecified if ongoing), notes: There is a history of alcohol use consumed occasionally; "Patient uses caffeine" (unspecified if ongoing), notes: The patient uses caffeine; "Smoking status: Never smoker" (unspecified if ongoing); "Cervical cancer", start date: 01Mar2018 (unspecified if ongoing). Concomitant medication(s) included: IMVEXXY, start date: 30Aug2020 (ongoing); PREDNISONE, start date: 28Apr2021 (ongoing); TOPROL XL, start date: 08Oct2020 (ongoing); METOPROLOL SUCCINATE, stop date: 22Jul2021. Past drug history included: Known allergies:pseudoephedrine, reaction(s): "Hives", notes: Known allergies:Pseudoephedrine. The following information was reported: CHEST PAIN (non-serious) with onset 19Aug2021, outcome "recovering", described as "chest pain/ aching"; FEELING ABNORMAL (non-serious) with onset 19Aug2021, outcome "unknown", described as "squeezing sensation"; DYSPNOEA (non-serious) with onset 19Aug2021, outcome "recovered" (2021), described as "cannot take a deep breath/difficulty breathing"; OXYGEN SATURATION ABNORMAL (non-serious) with onset 19Aug2021, outcome "unknown", described as "her oxygen levels had dropped"; COUGH (non-serious) with onset 2021, outcome "unknown", described as "Dry cough"; PALPITATIONS (non-serious) with onset 2021, outcome "recovered" (2021), described as "palpitations"; DYSPNOEA PAROXYSMAL NOCTURNAL (non-serious) with onset 2021, outcome "unknown", described as "Paroxysmal noctural dyspnea"; FATIGUE (non-serious) with onset 2021, outcome "unknown", described as "fatigue"; MALAISE (non-serious) with onset 2021, outcome "unknown", described as "malaise"; ASTHENIA (non-serious) with onset 2021, outcome "unknown", described as "generalized weakness"; CHEST DISCOMFORT (non-serious) with onset 19Aug2021, outcome "unknown", described as "chest tightness"; DYSPNOEA EXERTIONAL (non-serious) with onset 19Aug2021, outcome "unknown", described as "dyspnea on exertion"; CHILLS (non-serious) with onset 2021, outcome "recovered" (2021), described as "chills"; HEART RATE IRREGULAR (non-serious) with onset 2021, outcome "unknown", described as "Irregular heartbeat"; PAIN (non-serious) with onset 2021, outcome "unknown", described as "pains all over her body"; DIZZINESS (non-serious) with onset 2021, outcome "unknown", described as "Occasional dizziness"; JOINT SWELLING (non-serious) with onset 2021, outcome "unknown", described as "knee swelling"; BLOOD PRESSURE SYSTOLIC INCREASED (non-serious) with onset 2021, outcome "unknown", described as "systolic blood pressure increased 142/80". The events "chest pain/ aching", "squeezing sensation", "cannot take a deep breath/difficulty breathing", "her oxygen levels had dropped", "chest tightness" and "dyspnea on exertion" were evaluated at the physician office visit. Relevant laboratory tests and procedures are available in the appropriate section. Therapeutic measures were taken as a result of chest pain, feeling abnormal, dyspnoea, oxygen saturation abnormal, cough, palpitations, dyspnoea paroxysmal nocturnal, fatigue, malaise, asthenia, chest discomfort, dyspnoea exertional, chills, heart rate irregular, pain, dizziness, joint swelling, blood pressure systolic increased.  Additional information: Patient came in for chest pain, patient had received her vaccine about a month ago and she has been having chest pain every since. Patient states it's like a squeezing sensation and cannot take a deep breath. The patient did not have covid prior to vaccination. The patient didn't test for covid post vaccination. The patient was not seen in the Emergency Department. The patient was not hospitalized. The patient was not admitted to an Intensive Care Unit. The patient had dry cough and difficulty breathing (without wheeze or stridor). The patient did not have sensation of throat closure, sneezing or Rhinorrhea. The patient did not have Measured hypotension, Shock, Tachycardia, Capillary refill time > 3 sec, Reduced central pulse volume, Decreased level of consciousness and Loss of consciousness. The patient did not have Gastrointestinal or Any other symptoms/signs. The event did not require the initiation of new medication or other treatment or procedure. The patient did not take or have readily available any specific medication related to previous history of any allergies. The patient did not receive any recent vaccines for any other conditions prior to the event being reported. The patient did not receive any recent vaccines for SARS-CoV2 other than Pfizer-BioNTech COVID-19 Vaccine prior to the event being reported. The patient has not received any other vaccines around the time of Pfizer-BioNTech COVID-19 Vaccine vaccination. Referred to Cardiology today due to her symptoms and abnormal EKG. The patient has not fallen in the last year. The patient is not at risk for falls. The patient presents with a complaint of Chest pain. The symptoms began month ago and began gradually. The pain is in the center. The patient describes the pain as squeezing, tightness and aching. The pain does not radiate to the back, flank, or groin. The patient also complains of dyspnea, fatigue and palpitations. The symptoms are aggravated by after receiving her first phizer vaccine. Interventions the patient has tried have not provided any relief. The Chest pain is associated with dyspnea on exertion, generalized weakness, malaise and nocturnal dyspnea. There has been no prior diagnostics/screening. On 31Jul2021 patient had Pfizer COVID vaccine #1. That night patient had such severe chest pain lying down she thought she was having a heart attack. Sitting up helped. Has had this lying down intermittently since then. Looked up rare side effects which listed pericarditis. Has been subsiding since then where chest feels tight and has dull ache mostly when lying down. There were no changes in constitutional system like Change in appetite, rigors, Decreased activity, Fatigue, Fever, Fussiness, Generalized weakness, increased appetite, Irritability, Lethargy, Malaise, Night sweats, Pallor, Weight gain and Weight loss. Has gotten chills every evening for a very long time. The patient was not snoring. The patient had Dyspnea, Dyspnea on exertion, Paroxysmal nocturnal dyspnea. The patient did not have Accelerated respirations, Asthma, Cough, Cyanosis, Frequent Upper Respiratory Infection, Hemoptysis, Known TB exposure, Nocturnal dyspnea, Orthopnea, Painful respiration, Pleuritic pain, Sputum, Stridor, Use of accessory muscles for respirations and Wheezing. The patient would feel like she needed to cough for relief. Felt like she had a catch in chest. The patient had Chest pain, Irregular heartbeat/palpitations. The patient did not have Claudication, Cool extremity, Cyanosis, Edema, Pain (vascular), Raynaudls, Thrombophlebitis and Varicose veins. The patient had No jaw pain. No LUE pain or numbness, No diaphoresis. The patient did not have Decreased appetite, Diarrhea, Nausea and Vomiting. The patient did not have Nocturia. The patient did not have Paresthesia and Syncope. The patient did not have Insomnia. The patient did not have Erythema and Ulcer. The patient is post-menopausal (The year was 2003). Physical examination was done to the patient. General exam comments: Anterior chest wall NTTP. Constitutional exam normal, well developed. Neck exam normal, Inspection  Normal, Auscultation  Normal, Effort Normal. Lymph Finding: Normal, Details: No cervical or supraclavicular adenopathy. Respiratory Exam: Normal, Details: Inspection - Normal. Auscultation - Normal. No abdominal tenderness. Cardiovascular Exam: Normal, Details: Inspection - Regular rate and rhythm. No murmurs, gallops, or rubs. Vascular Exam: Normal, Details: Pulses - Dorsalis pedis: Normal. Capillary refill - Less than 2 seconds. Abdomen Exam: Normal, Details: Inspection - Normal. Auscultation - Normal. No abdominal tenderness. No hepatic enlargement, No spleen enlargement. No hernia. Extremity Exam: Normal, Details: No edema. Psychiatric Exam: Normal, Details: Orientation - Oriented to time, place, person & situation, Appropriate mood and affect. Normal insight. Normal judgment. The patient visited Clinic for evaluation of chest pain. She had her First covid-19 vaccine 31Jul. Three days later she started have central pain. Worse with laying down. Sharp in quality. Her pain has mostly resolved. Has some residual chest tightness. She states it worse with stressed, No exertional compartment. No fevers or Chills. She has not had covid-19. No complaints of shortness of breath. No complaints of palpitations, Occasional dizziness, No syncopal events, Denies lower extremity swelling, PHD and orthopnea, Has knee swelling, No focal weakness or slurred speech. She states that she gets pains all over her body. This has been BP 120-140/80s. Had chest pain after her vaccine. Possible SE to vaccine: Pericarditis has been seen. It is rare and usually in younger men, No PR depression or ST elevation on EKG. No friction rub on exam. Here initial pain has resolved. It has now dissipated, now having CP only when stressed. No exertional component. No ischemic changes on EKG. Atypical fur ischemic heart disease, Will check an echocardiogram to evaluate for structural heart disease. R07.9: Chest pain, unspecified Electrocardiogram. High blood pressure, care instructions.   No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.