Age: 33.0
Sex: F
Vaccine: COVID19
Symptoms: Brain natriuretic peptide normal, C-reactive protein normal, Cardiovascular evaluation, Chest X-ray normal, Chest discomfort
Clinical narrative: I did not experience any flu-like symptoms or any other symptoms until 4 days after my 2nd Pfizer dose. My 2nd dose was on 1/28/21 and my symptoms began on 2/1/21. The symptoms began suddenly. Around 7pm I was talking on the phone with a friend while packing clothes for a trip. I began experiencing chest pain, rapid heart rate, and feeling like I was going to pass out. I tried walking to another room, to sit down, but the feeling persisted. I also tried walking to my car to see if I could drive to urgent care, but it was difficult as the dizziness and feeling of near syncope intensified. I call the ambulance where they came and took my vitals. My blood pressure was elevated at 198/100. I do not suffer with high blood pressure as it is usually almost perfect at 120/80. Also, at the time the ambulance was called my heart rate was grossly elevated although I do not remember the exact number. At the ER, they completed an EKG, X-Ray, Troponin I, CBC, urinalysis, and pregnancy test which all came back normal. My oxygen saturation was normal at 98% and oral temperature was not elevated. I was given a saline drip and ketorolac (Toradol) which is an anti-inflammatory. At discharge my blood pressure had dropped down to 142/83, but I was still experiencing the chest pain. I was diagnosed with lightheadedness, hypertension, and chest discomfort.   On 2/2/21 I returned to the ER with again with chest pain and elevated blood pressure. Here they repeated another EKG and Troponin I blood test. I was given Acetaminophen and discharged home. My blood pressure at discharge was 133/91. My diagnoses at discharge was chest pain.  I was told to follow up with internal medicine for high blood pressure. I took off work and rested for an additional 2 more days after that and took classes from home where the symptoms seemed to resolve. I experienced shooting chest pain intermittently during this time. Upon following up with internal medicine and taking my blood pressure everyday I was back to normal in about 4 days after my initial ER visit.  Eventually all of the symptoms subsided. Around May or June I started experiencing what I thought was intermittent left breast pain; however, the pain became apparent that it was my chest/heart at the end of June. After roughly 3 days of mild, but persistent chest pain I went to the ER. I was given an EKG, Chest X-Ray, BNP, CBC, Pregnancy, and Troponin I test. All were clear with the exception of the EKG. It was noted that the EKG was borderline abnormal as compared to my EKG back in February. I was given a saline drip and Tylenol. I was told to follow-up with Internal Medicine.  It has been an uphill battle since then and I am trying to get help as I cannot function as normal to complete day-to-day tasks like work, driving, or even walking more than a few feet. My symptoms have worsened to include heart palpitations during exertion, continued dizzy and sometimes nausea, and trouble sleeping due to pain and shortness of breath when lying down or on my back. I also experienced a TIA (mini stroke). The details of these events and subsequent 5 ER visits beginning in July 2021 are explained below.  On July 4, 2021, I got my first dizzy spell and feeling like I was going to pass out. My heart rate increased drastically to about 160 bpm without any exertion. I just walked to the couch to sit in the air condition. I sat down and cooled myself with a cold compress and the symptoms resolved in about 10 minutes. The same things occurred on 7/5 and 7/6. (I took Motrin 600 from 7/3 -7/6 and the chest pain was almost non-existent; however, I stopped taking it because I thought it may have been the cause for what was making me dizzy). Over the next few days I also began to feel weird numbness and tingling down my left arm with continued dizziness.   I saw Internal Medicine on 7/7/21 and described my symptoms where he runs blood work (all came back normal) and then refers me to cardiology and the breast clinic (to rule out breast pathology). I see cardiology on 7/8/21 where she orders bloodwork for sedimentation rate and a high sensitivity CRP, and also a future appointment to get a holter monitor.   Due to the continued severe dizziness while waiting for the cardiology blood work to come back, I go back to the ER on 7/10 where they did tests the same tests as above (EKG, Troponin I, BNP, ISTAT, and urinalysis); however, this time they also did blood work for C-reactive protein and sedimentation rate. My c-reactive protein was in range, but my sedimentation rate (ESR) was elevated at 49 where the normal cut off is 36.  I was discharged with no medication.  Frustrated with no help I began to take Motrin 600 (7/10-7/12) as an anti-inflammatory hoping that would work. My symptoms improved drastically, and I was able to walk around and at least go to work without feeling dizzy or the chest pain. However, on 7/12 after a full day at work I was headed out the door where I began to feel dizzy but tried to push myself to walk down the long corridor to get to my car in the parking garage. It felt like I was going to black out before I got there so I had to sit down to rest several times. Once I made it I was able to sit in the car and calm my heart rate down after drinking some water; however, after I began to drive for 5 minutes I started to feel a heaviness over my head and limbs like I was going to pass out so I pulled over. When I did, my face, and the left side of my body became paralyzed/numb and I could not move. I called the ambulance where I was taken in as a stroke activation to hospital. My blood pressure was elevated at around 155/100, and my heart rate was again elevated. I was given Ketorolac (Toradol) and after a negative head CT, I was diagnosed with a Transient Ischemic Attack (TIA) or ?mini stroke?. I continued to be weak on my left side for the next day or so.  I continued to have multiple doctors appointments to rule out other pathologies (OB/GYN, mammogram, ultrasound, etc). However, all my tests kept coming back normal. I began experiencing heart palpitations, and also pain and shortness of breath when laying down or on my back. It was also apparent that all of my symptoms were worse with any form of exertion, especially ascending steps, standing for long periods of time, or walking even short distances.  On 7/18/21 I could not get out of the bed (severe dizziness and nausea accompanied the chest pain). I was given a chest, abdomen, and pelvis CT, as well as an MRI of my head and neck. nothing was found in these tests, or the usual ER tests (troponin, ekg, etc.); however, my sedimentation rate was again elevated at 48 where the cut off is 36. My c-reactive protein was normal. I was discharged.   I returned to the ER again on 7/31/21, this time for severe chest pain and my heart racing/beating like it was going to come out of my chest.  I called the ambulance where they checked my vitals. My blood pressure again was around 145/98 and my heart rate was severely elevated. Prior to calling the ambulance I tried to take a motrin for the pain, but about an hour later is when I began having the severe heart palpitations. I was given asprin in the ER and felt much better at discharge. I began feeling bad the next night but took more asprin and felt well enough to go to sleep without the pain and shortness of breath.   My symptoms continue to this day (8/3/21). I still have very bad dizziness, heart palpitations, and chest pain. I also feel the pain on the upper portion of my back behind my chest wall. It is difficult to sleep due to the pain and shortness of breath laying down. I am unable to go into work, drive, walk anywhere more than a few feet, or complete basic daily living activities without assistance. I have been to the ER 7 times now for these incidents. I am now begging my physician to move up my cardiac MRI so that we can get to the bottom of this and get me treated, but have not had any luck due to backlogs. My echocardiogram at rest was normal.  I have never had any other previous health conditions prior to this.