Age: 86.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Anticoagulant therapy, Asthenia, Brain natriuretic peptide, Brain natriuretic peptide increased, COVID-19
Clinical narrative: MYOCARDIAL INFARCTION; COVID-19; COUGH; PAIN; MALAISE; CHILLS; ASTHENIA; SARS-COV-2 TEST POSITIVE; BRAIN NATRIURETIC PEPTIDE INCREASED; TROPONIN INCREASED; ANTICOAGULANT THERAPY; STENT PLACEMENT; This spontaneous report received from a health care professional by a Regulatory Authority VAERS (Vaccine Adverse Event Reporting System) (VAERS ID: 2267352) concerned an 87 year old female. The patient's height, and weight were not reported. The patient's past medical history included: myocardial infarction, and stent placement, and concurrent conditions included: peripheral vascular disease (PVD), atherosclerotic heart disease of native coronary artery with other forms of angina pectoris, renal artery stenosis, carotid artery stenosis, type 2 diabetes mellitus (with long-term current use of insulin), essential hypertension, hyperlipidemia, anxiety, ischemic cardiomyopathy, thyroid nodule, chronic kidney disease (CKD) stage 4 (GFR (glomerular filtration rate)- 15-29 ml/min), retinopathy diabetic right eye, bronchial neoplasm, lymphadenopathy mediastinal, diffuse large B-cell lymphoma of intrathoracic lymph nodes, antineoplastic chemotherapy induced anemia, multinodular goiter, steroid-induced hyperglycemia, basosquamous carcinoma, lipoma of neck, vitamin D deficiency, hyperkalemia, secondary hyperparathyroidism of renal origin, iron malabsorption, atrial fibrillation, non-smoker, non alcohol user, and Altace (ramipril) allergy, and other pre-existing medical conditions included: Patient denies drug abuse or illicit usages. The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 1805018 expiry: Unknown) dose was not reported, 1 total administered on 20-MAR-2021 for an unspecified indication. Age at time of vaccination 86 years old. Concomitant medications included Jardiance (empagliflozin), Aspirin (acetylsalicylic acid), Norvasc (amlodipine besilate), Lipitor (atorvastatin calcium), Calcium with D3 (calcium/colecalciferol), Plavix (clopidogrel bisulfate), Feosol (ferrous sulfate), Lasix (furosemide), Nitrostat (glyceryl trinitrate), Imdur (isosorbide mononitrate), Mag-Ox (magnesium oxide), Toprol XL (metoprolol succinate), Zoloft (sertraline hydrochloride), and sodium bicarbonate for drug used for unknown indication. Levemir (insulin detemir) for type 2 diabetes mellitus. On 28-JAN-2022, patient had (with 2-day history) of generalized body aches. She has also had a non-productive cough, chills and malaise. She denies any shortness of breath, chest pain, headaches or nausea, vomiting and diarrhea, leg swelling pain with inspiration abdominal pain problems with urination or stooling. She told that her daughter had similar symptoms about a week ago and that the patient was around her frequently. She told that she was recently hospitalized (dates unspecified) for a heart attack (Myocardial infraction) and dual stent placement. She had been taking all of her medications but has not tried anything over the counter to help with her symptoms. In the ED (emergency department) patient hemodynamically stable. Labs notable for elevated troponin at 384 and BNP (Brain natriuretic peptide) 26140 with concern for NST EMI (non-ST-segment elevation myocardial infarction) patient was given full dose aspirin and started on heparin gtt. Patient is fully vaccinated and subsequently tested positive for COVID-19. Patient admitted to the general medicine service for evaluation and further management. Cardiology was consulted for further management and assess possible catheterization versus medical therapy. Since she was fully vaccinated for COVID and she did not experience respiratory symptoms will hold on antivirals on discharge. Her heparin drip was discontinued and patient does not need further anticoagulation at this time. Therapies recommend home physical therapy so she will have home care services. Patient improved and discharged in stable condition. She is to hold on losartan given softer blood pressures defer to cardiology when to resume medication. Her home amlodipine and lopressor were discontinued She was to start Metoprolol Succinate. She was to continue her other home medications as prescribed. The patient was hospitalized for 3 days. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient recovered from myocardial infarction, covid-19, asthenia, chills, cough, malaise, pain, sars-cov-2 test positive, brain natriuretic peptide increased, troponin increased, anticoagulant therapy, and stent placement. This report was serious (Hospitalization Caused / Prolonged). This report was associated with product quality complaint: 90000233321. The suspected product quality complaint has been confirmed to be the reported allegation was not confirmed and the root cause was determined to be not manufacturing related. Batch and lot tested and found within specifications, based on the PQC evaluation/investigation performed.  Additional information was received from central complaint vigilance department on 15-JUN-2022. The following information was updated and incorporated into the case narrative: Product quality complaint investigation result.; Sender's Comments: V2-The following information was updated and incorporated into the case narrative: Product quality complaint investigation result.This updated information does not alter the causality of previously reported events.  20220543550-covid-19 vaccine ad26.cov2.s-Myocardial infarction, Stent replacement, Troponin increased, Brain natriuretic peptide increased. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There are other factors more likely to be associated with the event(s) than the drug. Specifically: MEDICAL HISTORY, UNDERLYING DISEASE. Therefore, this event(s) is considered not related.(Myocardial Infarction)  20220543550-covid-19 vaccine ad26.cov2.s-Covid-19, cough, Pain, Malaise, chills, Asthenia, SARS-COV2- Positive, Anticoagulant therapy. The event(s) has a compatible/suggestive temporal relationship, is unlabeled, and has unknown scientific plausibility. There is no information on any other factors potentially associated with the event(s). Therefore, this event(s) is considered unassessable.