Age: 70.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Alanine aminotransferase, Albumin globulin ratio, Anion gap decreased, Aspartate aminotransferase, Atrial fibrillation
Clinical narrative: I was given the 2nd dose of the Pfizer vaccine at 8:48 AM at the Center for Covid-19 Vaccines.  During the observation time, as with what also happened with the 1st dose, my heart rate went up from 50s to 80s shortly after receiving the 2nd dose, but I felt ok.  About  1 ½ hr after the 2nd dose, the pulse was up to the 90s.  About 2 hrs after the 2nd dose the pulse was up to 105. Very soon after, and it seemed suddenly, within less than 3 hrs of the 2nd dose, the HR was up to 156.  I was shakey.  Then intense center chest pain began and I felt very poorly.  As suggested I had remained at Center to be near the ER, where I went by wheelchair.   8/11/21 Labs, four 8/11/21 Ekgs, 8/12/21 chest xray, and 8/12/21 echo were done at the ED. The 1st EKG was done behind the check in desk at 11:46 AM w/ BPM 150 and Afib with rapid ventricular response, RVR,  and incomplete right bundle branch block. Since HR was in 150s, the EKG was redone 12:14 PM w/ BPM 136 w/ afib w/ RVR and right bundle branch block. I was soon taken back to ED hallway, where I stayed for about 10 hrs.  I made it clear that considering my long list of allergies over many years to varied meds, I needed to discuss any new cardio meds with a cardiologist.  I did not want more problems.  I was told I would be admitted and could then discuss the afib meds with a cardiologist, but late in the evening I was told I would be sent to ED Observation Unit, not admitted.  I did not realize that I would not be talking with a cardiologist.  The 8/11/21 8:36 PM EKG stated "Vent 66 BPM. Sinus rhythm with occasional Premature atrial complexes...Sinus rhythm has replaced atrial fibrillation. Vent rate has decreased by 70 BPM. Incomplete right bundle branch block has replaced right bundle branch block. "    8/11/21 10:53 PM EKG showed Vent rate 72 Normal sinus rhythm. Premature atrial complexes are no longer present.  Afib was no longer detected on EKGs the evening of 8/11/12 or on the echo 8/12/21 morning.   I was discharged 8/12/21. Since I had not had the opportunity to discuss any new meds with a cardio, I refused any new meds other than the diltiazem and metoprolol while in the ED.   Per the provider Notes: "Patient found to have new onset atrial fibrillation wit RVR," "Admit to medicine for new afib," "New afib adverse reaction to covid vaccine," "Patient presents with allergic reaction," "Pt with new onset afib with rvr controlled easily with dose of iv dilt... Has many medication allergies and is difficult to manage."       9/28/21 I ended up in ED at Medical Center with a bout of afib with HR up to 130s.  At ED, meds were discussed with cardio and I was discharged 9/29/21 with afib meds of Eliquis and metoprolol tartrate.  As it turned out, I had reactions to the prescribed metoprolol, including breathing problems and chest tightness.   On 10/19/21 daily metoprolol was changed to diltiazem, as needed only.  I have not had afib since 10/18 - 10/19/21 so I have not needed to take the diltiazem yet, and therefore do not yet know how I will tolerate it.     Prior to the Pfizer covid vaccine I had never been diagnosed with afib, nor ever experienced it to my knowledge, and I use my oximeter with a rhythm tracker several times daily.   When I attempted to get my 1st covid vaccine dose on 5/21/21, the nurse and doctor refused to give it to me based on my allergy history and their prior experience with a  person with a similar allergy history who had not fared well after the vaccine. I was told to see an allergist.  In July I was cleared by a nurse who was on a Covid Vaccine Project working in the allergist office. The appointment with the allergist was not available until October.   Following the 1st dose on 7/22/21, my HR had gone up to 110s from 50s, with slight chest discomfort, but I did not go to the ER.  After hearing of my reactions to the 1st dose, the nurse giving the 2nd dose was very reluctant to give me the 2nd dose.  She made a call.  I think it was to confirm the clearance for the 2nd dose.   I do not remember all the details, but as my allergies to meds mounted, a doctor years ago suggested that I not get any vaccines.  I have not received any except a tetanus shot as far back as I can remember, until the covid vaccine.     I hope to hear from someone at VAERS.  I can answer any questions you might have.  I also need very much to know how the CDC feels about my receiving a booster or not, due to my reactions.  The CDC chart seems to indicate that tachycardia following the 1st dose indicates that the 2nd dose is not recommended.  Thank you.