chrisvoncsefalvay/vaers-narrative-generation huggingface dataset:
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Ascites, Aspartate aminotransferase increased, Beta-2 glycoprotein antibody negative, Bilirubin conjugated, Blood bilirubin increased
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Blood fibrinogen increased, Blood pH increased, Blood test, Blood triglycerides normal, Body temperature increased
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Brain natriuretic peptide increased, C-reactive protein increased, Cardiac imaging procedure abnormal, Coagulation factor V level decreased, Coagulation factor VII level decreased
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Coagulation factor X level normal, Computerised tomogram abdomen abnormal, Computerised tomogram pelvis abnormal, Computerised tomogram thorax, Condition aggravated
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Coronary artery occlusion, Coxiella test, Cytomegalovirus test positive, Deep vein thrombosis, Diarrhoea
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Dyspnoea exertional, Echocardiogram abnormal, Ejection fraction decreased, Enterovirus test negative, Epstein-Barr virus test negative
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Fibrin D dimer increased, Generalised oedema, HIV test negative, Haemoptysis, Haemorrhage
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Heart valve incompetence, Hepatitis C test negative, High density lipoprotein decreased, Human herpes virus 6 serology negative, Intensive care
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: International normalised ratio increased, Intestinal angioedema, Jugular vein thrombosis, Low density lipoprotein normal, Lung opacity
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Lymphadenopathy, Myocardial infarction, Orthopnoea, PCO2 normal, Parvovirus B19 test negative
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Peripheral swelling, Pleural effusion, Portal hypertension, Portal vein embolism, Protein C
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Protein S, Prothrombin level normal, Pulmonary embolism, Pulmonary infarction, Q fever
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Renal infarct, SARS-CoV-2 antibody test, SARS-CoV-2 antibody test negative, SARS-CoV-2 antibody test positive, SARS-CoV-2 test negative
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Scan with contrast, Splenic infarction, Splenic vein thrombosis, Tachycardia, Thrombin time prolonged
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Thrombophlebitis superficial, Troponin increased, Ultrasound Doppler abnormal, Urine analysis normal, Venogram normal
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 44.0
Sex: M
Vaccine: COVID19, COVID19
Symptoms: Venous thrombosis, Ventricular hypokinesia, Weight increased, White blood cell count increased
Clinical narrative: Patient  developed episode of diarrhea shortly after 1st shot in series,  this was followed by  lower extremity swelling and mild dyspnea on exertion, that quickly exacerbated after the 2nd shot on 5/15/2021,  that resulted in severe dyspnea on exertion, severe lower extremity swelling with approximately 25 lb weight gain, orthopnea and hemoptysis. Patient reported temperatures of 99.2 F to 99.8 F.   Outside CT chest abdomen pelvis angiogram showed moderate to large acute segmental/subsegmental pulmonary emboli with trace right heart strain and right lower lobe pulmonary infarction, moderate right pleural effusion, acute splenic vein thrombosis with extension to the proximal portal vein and associated splenic infarcts, bilateral renal infarcts, and evidence of portal hypertension. He was transferred to the Hospital for further management. Upon presentation here he was tachycardic but with stable blood pressures and requiring up to 5 L by nasal cannula. Initial laboratory studies were notable for WBC 21.0, INR 1.8, D-dimer 11653, NT pro-BNP 17684, troponins 603 to 579 to 574, CRP 127. He was started on a heparin infusion. He was admitted to the MICU for further management.   Bedside ultrasound demonstrated reduced biventricular contractility. He was given two doses of 40 mg intravenous furosemide with about 3.5 L of urine output since admission (net negative 3.1 L). His oxygen was weaned to 1 L by nasal cannula. Lower extremity venous and arterial Dopplers were negative.  Subsequent imaging  demonstrated a transperineal inferior infarct with akinesis of the inferior septum, inferior and inferior lateral walls with apical and mid ventricle akinesis secondary to a complete occluded RCA.  moderate pericardial effusion without tamponade noted.  Upper extremity ultrasound demonstrated acute DVT in the lower right IJ, innominate, subclavian and proximal axillary veins.  MRI  venogram was negative for clots, but multiple acute and subacute enhancing infarcts within all 3 vasculature distributions consistent with embolic etiology were noted.  TTE showed of mural thrombus along the septal and inferior walls of the LV apex,  severely enlarged left ventricle with EF of 20%, severe hypokinesis.    Patient was aggressively IV diuresis, with improvement in respiratory status.  Maintained on  high-intensity heparin for pulmonary emboli, DVT, and diffuse arterial and venous thrombosis.  He was bridged to warfarin.  Patient was  prescribed LifeVest for primary prevention. Started on beta-blocker and ACE-inhibitor given EF.     Patient planning on discharge 6/5-6/07, outcome pending.
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Asthenia, Dizziness, Hyperhidrosis, Hypoacusis, Malaise
Clinical narrative: Pt did well before and after vaccination.  A few minutes later in the waiting area he started feeling ill and his mom had him sit down and she called 911.  He complained of weakness, diminished sight and hearing and lightheadedness.  He was very pale and sweaty.  With his mom's permission I activated an ammonia inhalant near his nose.  He said he felt better after the 2nd sniff.  After a couple minutes he said his symptoms were greatly diminished and he was ok.  The paramedics arrived and pt was able to walk to the ambulance for further evaluation.  A paramedic came back and said the patient is feeling much better and declined to go to the hospital.  I talked to the mom a couple hours later and she said he is all better.
Age: 14.0
Sex: M
Vaccine: COVID19
Symptoms: Pallor, Visual impairment
Clinical narrative: Pt did well before and after vaccination.  A few minutes later in the waiting area he started feeling ill and his mom had him sit down and she called 911.  He complained of weakness, diminished sight and hearing and lightheadedness.  He was very pale and sweaty.  With his mom's permission I activated an ammonia inhalant near his nose.  He said he felt better after the 2nd sniff.  After a couple minutes he said his symptoms were greatly diminished and he was ok.  The paramedics arrived and pt was able to walk to the ambulance for further evaluation.  A paramedic came back and said the patient is feeling much better and declined to go to the hospital.  I talked to the mom a couple hours later and she said he is all better.
Age: 45.0
Sex: F
Vaccine: COVID19
Symptoms: Muscular weakness, Musculoskeletal stiffness
Clinical narrative: Within 5 minutes after vaccine administration, patient reported weakness in the left arm (same arm as the vaccination) from the shoulder to her hand. She also reported stiffness in the left side of her neck. Symptoms did start to improve after 30 minutes.
Age: 13.0
Sex: M
Vaccine: COVID19
Symptoms: No adverse event, Product administered to patient of inappropriate age
Clinical narrative: The Moderna vaccine was accidentally given to this 13 year old - rather than the Pfizer vaccine. Both the PCP and the mother have been notified of the error. At the time of this writing, the child has not suffered any adverse event pertaining to the vaccine error.
Age: 50.0
Sex: F
Vaccine: COVID19
Symptoms: Injection site bruising, Injection site erythema, Injection site swelling, Myalgia, Pain
Clinical narrative: Extreme muscle pain covering full body lasting full day after second injection.  Swelling at injection site.  Bruised feeling at injection site.  Tylenol did not help alleviate the pain.  Aleve taken and seemed to help the pain, but not relieve it entirely.  Muscle pain completely gone the second morning after injection.  Still redness, swelling and slight "bruised" pain at injection site.
Age: 31.0
Sex: M
Vaccine: COVID19
Symptoms: Loss of consciousness, Nervousness, Urinary incontinence
Clinical narrative: patient states he was very nervous and worked himself up, patient then describes blacking out and urinating on himself, he did not request assistance and left after 15 minute wait time without notifying vaccine/clinic staff.  His wife called later to notify us of his adverse effect.
Age: 68.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Blood test, Muscle spasms, Soft tissue inflammation, X-ray
Clinical narrative: Muscles of arms and legs bunch up like a charlie horse and the soft tissue i inflamed.
Age: 29.0
Sex: F
Vaccine: COVID19
Symptoms: Body temperature fluctuation, Feeling cold, Headache, Hot flush, Injection site erythema
Clinical narrative: Headache, arm pain, injection site swelling, site redness, site hardness, site pain, site itching, site rash <still spreading>, site expressing excessive heat, hot flashes, cold spells, body temperature irregularities