Sex: F
Vaccine: COVID19
Symptoms: Cardiac stress test, Chest discomfort, Computerised tomogram thorax, Exercise tolerance decreased, Fatigue
Clinical narrative: intermittent chest discomfort several days after receiving her first dose of the Pfizer-BioNTech COVID-19 vaccine; unexplained fatigue; diminished exercise capacity; dynamic troponin elevation peaking at 177 ng/L; This is a literature report for the following literature source(s):  A 59-year-old female patient received BNT162b2 (BNT162B2), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history included: "mild COVID infection" (unspecified if ongoing). The patient's concomitant medications were not reported. The following information was reported: CHEST DISCOMFORT (medically significant), outcome "recovered", described as "intermittent chest discomfort several days after receiving her first dose of the Pfizer-BioNTech COVID-19 vaccine"; FATIGUE (medically significant), outcome "unknown", described as "unexplained fatigue"; EXERCISE TOLERANCE DECREASED (medically significant), outcome "unknown", described as "diminished exercise capacity"; TROPONIN INCREASED (medically significant), outcome "unknown", described as "dynamic troponin elevation peaking at 177 ng/L". The events "intermittent chest discomfort several days after receiving her first dose of the pfizer-biontech covid-19 vaccine", "unexplained fatigue", "diminished exercise capacity" and "dynamic troponin elevation peaking at 177 ng/l" required emergency room visit. The patient underwent the following laboratory tests and procedures: Cardiac stress test: failed to demonstrate an etiology, notes: after dose 1; Computerised tomogram thorax: failed to demonstrate an etiology after dose 1; ambulatory cardiac monitoring: failed to demonstrate an etiology after dose 1; Magnetic resonance imaging heart: revealing edema in the basal lateral wall and late, notes: gadolinium enhancement in a subepicardial distribution, suggestive of myocardial inflammation; performed two weeks later showed complete, notes: resolution of myocardial edema with residual subepicardial LGE in the basal lateral reevaluation in the Cardiology clinic; Troponin: 177 ng/L, notes: dynamic troponin elevation peaking. Therapeutic measures were taken as a result of chest discomfort, fatigue, exercise tolerance decreased, troponin increased.  Clinical course: Patient developed unexplained fatigue, diminished exercise capacity, and intermittent chest discomfort several days after receiving her first dose of the Pfizer-BioNTech COVID-19 vaccine. She was seen in the emergency department at the onset of symptoms and found to have a dynamic troponin elevation peaking at 177 ng/L. A comprehensive workup including regadenoson stress testing, CT scan of the chest with contrast, and ambulatory cardiac monitoring failed to demonstrate an etiology.; Sender's Comments: As per the available information the causality of the events chest discomfort, fatigue, exercise tolerance decreased, troponin increased with the suspect can not be ruled out completely. The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Ethics committees, and Investigators, as appropriate.,Linked Report(s) : US-PFIZER INC-PV202200130060 Same Article, patient, drug and different event and dose;