Age: 45.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Nausea, Palpitations, Tachycardia
Clinical narrative: Started within a few minutes after vaccine was administered. Accelerated heart palpitations, elevated high blood pressure and nausea. Stabilized about 30 minutes after. Since then heart palpitations have been up and down (over a month).   March 30 - Doctor appointment.   Dr notes: Patient presents with  PALPITATIONS x 2 weeks, the last 2 days have been really bad per patient. Patient states she started getting the palpitations post covid vaccine on 3/6/21. Moderna vaccine received.   Patient received Moderna Vaccine  3 weeks ago   10 min after vaccine started with palpitations , nausea  Cold feeling , BP was high  HR was 115 about , waited x 40 min felt better , BP 135/ Patient did not have pain with injection 1 we 1 week later  Went to store to buy food had   Had palpitations  For no reason, no chest pain  short of breath dizziness  +  Mild cold sweat ,+ nausea, unable to drive , had to take mask off, husband drove her home, once  She was home felt better . Lasted 10 min . Was good for 1 week , and today  At home  Started with palpitations  At 6 Am  Drank water , felt better  no associate symptoms  This time , lasted  15 min and had small  Feelings of palpitations  Lasting seconds during the day   Never had palpitations before , patient worries about everything  , whole family is home  Patient thinks she worried about the vaccine once she got it  No drugs  , no  weight loss  , usually hydrating  No caffeine  No history heart disease  Review of Systems  Constitutional: Negative for chills, diaphoresis and fever.  Cardiovascular: Positive for palpitations. Negative for chest pain and leg swelling.  Respiratory: Negative for cough and shortness of breath.   Gastrointestinal: Negative for diarrhea and nausea.  Neurological: Negative for dizziness.  Psychiatric/Behavioral: The patient is nervous/anxious. Physical Exam  Constitutional: She is well-developed, well-nourished, and in no distress. No distress.  Neck: No thyromegaly present.  Cardiovascular: Regular rhythm. Tachycardia present.  No murmur heard.  ER Visit on Apr 2, 2021 CHIEF COMPLAINT: PALPITATIONS  TRIAGE NURSE  PRESENTING HISTORY Information provided by: PATIENT History of Present Illness: Palpitations off and on x two weeks.  Denies chest pain. General Appearance-DistressLevel: MILD Industrial Related: NO   Patient is a 45 year old female with off and on palpatations x 1 week. Patient denies fever, chills, chest pain, SHORTNESS OF BREATH,  headache, nausea,  vomiting, diarrhea, abdominal pain,  dysuria, hematuria, cough, rash or flank pain.  Patient also feeling anxiety during this time.    Initial VS: BP: 132/83 / Pulse: 132 / Temp: 97.6 °F (36.4 °C) /   / SpO2: 100 %    Physical Exam Vitals signs and nursing note reviewed.  Constitutional:      General: She is not in acute distress.    Appearance: She is well-developed. She is not diaphoretic.  HENT:     Head: Normocephalic.  Eyes:    Conjunctiva/sclera: Conjunctivae normal.  Neck:    Musculoskeletal: Normal range of motion.  Cardiovascular:    Rate and Rhythm: Tachycardia present.  Pulmonary:    Effort: Pulmonary effort is normal.     Breath sounds: No stridor.  Musculoskeletal: Normal range of motion.  Skin:   General: Skin is warm and dry.  Neurological:    General: No focal deficit present.     Mental Status: She is alert and oriented to person, place, and time.  Psychiatric:       Thought Content: Thought content normal.  ASSESSMENT:Plan  Anxiety and palpitations. Work up pos for UTI. Patient non toxic with no fever, leukocytotic or lactic acidosis. Patients hr improved with fluids and ativan. Patient pending tyroid panel. Patient discharged with rx for keflex and ativan. Patient agrees with plan and understands strict return precautions.   Additional information for Item 19:  CO2 22 mEq/L  21 - 31 mEq/L   More details on Labs for Apr 2 does not fit in the form. Lab result from April 2