Age: 34.0
Sex: M
Vaccine: COVID19
Symptoms: Pain, Painful respiration, Screaming, Serum ferritin increased
Clinical narrative: I am reporting a possible incident of pericarditis following my 4th Moderna vaccine shot (2nd booster). However, I cannot definitively confirm that my symptoms were caused pericarditis or that it was related to my Covid-19 booster. I only recently found out about the link between the booster and pericarditis while checking the website to find out when I was due for my next booster. I discussed that report with my cardiologist and he told me that he could not exclude the possibility of a vaccine related event and that I could report it to VAERS for evaluation. I have included this correspondence at the bottom of my report.  I have a serious chronic illness. The symptoms I had during this possible adverse reaction were unlike anything that I have experienced before or since. I kept a daily symptom journal at the time to document it.   Symptoms developed suddenly on 8/1/22 in the mid afternoon while sitting in a recliner. Pain began quickly building under my left collarbone and on the back left side of my rib cage. The pain was constant but would become extremely sharp and radiate throughout the left side of my chest and left shoulder whenever I would breath or cough. Pain became so severe that it was difficult to take a normal breath. Body temperature was around 99F to 100F. I took 1200mg of Ibuprofen that night and applied ice packs to my chest and back. That night the pain was so severe that sleep was difficult and could only take small short breaths or I'd scream out in pain. The only thing that seemed to help was if I sat up leaning forward to breath. Laying down seemed to worsen it.  On the morning of 8/2/22, my temperature was back up to 100F. The pain had lessened a bit from the previous night, but I still could not take a normal breath without significant pain. I took another 1000mg of ibuprofen to reduce my temperature and pain. I stopped taking my 100MG Modafinil because I was worried this could be a side effect of the newly started medicine. I had a routine primary care appointment at the clinic that day so I decided to go there instead of urgent care or the emergency room. I tried to discuss symptoms with my doctor, but I was struggling to breath and he attributed my condition to my chronic illness and would not investigate further. My blood pressure was lower than is typical for me at 100/78mm[Hg]. My average recorded blood pressure for the time before and after this event was 137/105mm. That night my pain  was at it's worst. On a numeric scale I would say it was a constant 7 increasing to a 10 if I took a normal breath. I continued alternating ice and heat and took another 800mg of ibuprofen. I had to prop myself sitting up on pillows to be able to get some sleep. On 8/3 the pain was less than the previous night and my temperature was back in the normal range. I still had to take shallow breaths to avoid the intense pain. I continued with the ice and ibuprofen.  By 8/4 the pain had lessened to the point that I could take normal breaths, but would still result in sharp pain levels of 8-9 on deep breaths or coughing.  Continued ice and ibuprofen. The pain improved each day until it was mostly gone by 8/7. By 8/16 all pain had completely resolved.   I discussed these symptoms first with LPN Psychiatrist at the Mental Health clinic since she had prescribed the modafinil for fatigue and brain fog. We decided to continue the modafinil cautiously to see if the symptoms would recur. They have not since recurred.   I also discussed the symptoms with my cardiologist, Dr. at Cardiology, at my appointment on 11/16/22 and asked if my symptoms could have been caused by pericarditis. He said that it was possible, but he couldn't be sure since it was not evaluated at the time.  On 11/21/22, I found a report on the website discussing a possible link between pericarditis and the mRNA Covid vaccines. I sent a message to my primary care and cardiologist asking for guidance on whether or not my incident was worth reporting. I have not yet received a response from my primary care doctor. In the interest of complete disclosure, please find my correspondence with my cardiologist below:  ------------------------------------------------------------------------ Addendum on November 21, 2022 16:05:59 EST  --------------------- From: (Cardiology Assoc - Patient Portal) To:  Viewable to:  Sent: 11/21/2022 16:05:59 EST Subject: FW: MD - Cardiology: Covid-19 Vaccination and Pericarditis       Please see response from Dr.       Addendum by MD, on November 21, 2022 15:59:03 EST  --------------------- From: MD,  To: Cardiology Assoc - Patient Portal; Viewable to:  Sent: 11/21/2022 15:59:03 EST Subject: RE: MD - Cardiology: Covid-19 Vaccination and Pericarditis Caller Name: Caller Number:  Dear Mr., The post COVID vaccine myocarditis typically starts with symptoms 1 week after the vaccination.  Most patients were in younger age groups.  Nevertheless, I can not totally exclude the possibility of a vaccine related event and I think you can certainly report the event for evaluation. To my knowledge ferritin is an acute phase reactant and the levels can be increased in the context of acute infections or inflammatory conditions.  It might be worthwhile repeating it by your PCP. I am less certain about. I hope this information is helpful. Sincerely,       MD --------------------- From: (Cardiology Assoc - Patient Portal) To: MD, RN,  Viewable to:  Sent: 11/21/2022 14:41:39 EST Subject: FW: MD - Cardiology: Covid-19 Vaccination and Pericarditis       Please see message from patient.             --------------------- From:  To: MD - Cardiology (Cardiology Assoc - Patient Portal) Viewable by:  Sent: 11/21/2022 01:18 p.m. EST Subject: Covid-19 Vaccination and Pericarditis Thank you for your message. It has been successfully sent to the appropriate care team. Good afternoon,  During my appointment on 11/16/22, we discussed some acute symptoms I had experienced on 8/1/22-8/16/22. As a quick recap, the onset of the symptoms was rapid with extreme pain developing under my left collarbone and on my back. It worsened when inhaling to the point that I was unable to take a full breath and was accompanied by a low fever of about 100F. It peaked on 8/2 and was most of the pain had abated by 8/8 with all noticeable symptoms gone by 8/16.  I received a Moderna Covid-19 booster on 7/14/22 and I just found out that is looking into cases of myocarditis and pericarditis related to this vaccine.  Due to the uncertainty of the situation, I wanted to check in with both you and my primary care team to find out if this incident rises to the level where I should report it to VAERS and if it would affect me getting my next Covid-19 booster.  I also wanted to ask if pericarditis could have been a potential cause for some abnormal lab readings from a blood test I received on 8/18, shortly after my symptoms had resolved. I had a high ANA Titer (1:160 with Homogeneous Pattern) and high Ferritin at 582 ng/mL. These readings were flagged to me by my gastroenterologist and I was told they could be related to infection, inflammation, or an autoimmune condition. My primary care physician put in a consult for rheumatology to investigate the high ANA, but the appointment is not until September of next year.  Thank you for your time and have a good day,  ------------------------------------------------------------------------