Age: 78.0
Sex: F
Vaccine: COVID19, COVID19
Symptoms: Echocardiogram, Hypertension, Palpitations, Troponin
Clinical narrative: BAD CHEST PAINS, PAIN IN CENTER OF CHEST; FEELING OF HEART NOT BEATING RIGHT; BLOOD PRESSURE OF 212; CELLULITIS IN HER WRIST; This spontaneous report received from a patient concerned a 78 year old female patient. The patient's height was 166 inches and weight was 138 pounds. The patient's concurrent conditions included white coat hypertension, asthma, severe allergy to codeine, abstain from alcohol, and non-smoker. The patient was not pregnant.  The patient received vaccination with covid-19 vaccine ad26.cov2. s (suspension for injection, intramuscular, batch number: 1805020, and expiry: UNKNOWN) dose was not reported, administered on 02-APR-2021 09:00 in left arm as prophylactic vaccination. Concomitant medications included estradiol.  The patient reported that about 15-20 minutes post-vaccination on 02-APR-2021 as she was waiting in waiting area of vaccination clinic, she started to get bad chest pain which was in the center of her chest. She experienced heavy pressure in her chest. No arm pain or sensation was reported other than her chest. The patient further explained that she could feel that her heart 'wasn't beating right' and reported as 'heart feeling wonky'. The patient felt the top of her heart beating faster than the bottom. The vaccination paramedic took her blood pressure which was 212 (patient did not have any other information on her blood pressure). The paramedics called ambulance and after a 15 minute drive patient arrived at emergency room at 9.30. The patient had an echocardiogram or 'an ultrasound' of her heart and was told that it was not functioning properly that her ventricle was functioning at 40% of normal. The patient was put on nitroglycerin and heparin drip. Blood test was also done which showed troponin levels at 113 or 116, 'somewhere in there'. The patient was told that 'some type of cardiac event had occurred'.  The patient's tests were reviewed same night and patient spent the night in emergency room because there were no beds. On 03-APR-2021, the patient was transferred to a hospital where she was put on nitroglycerin and heparin drip. The patient was moved again to another hospital on night of 04-APR-2021. The patient had angiogram and CT of vein and arteries. No clot was found by that time. The patient was discharged on 06-APR-2021. The patient saw a cardiologist on 15-APR-2021 who told patient that 'he thought she had some kind of clot that dissolved in the hospital'. Since patient has been home, she experienced pain and discomfort in arm and wrist with cellulitis in her wrist. The patient was taking cephalexin 500 mg three times a day for 10 days. The patient said it was due to angiogram she had because the angiogram team had hard time with her angiogram and had to go in twice. The patient had been taking percocet 5 mg tablet as needed for pain. The patient attempted to report these events online and left a message for someone to call her back but email did not work as she was unable to send.  The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The outcome of bad chest pains, pain in center of chest, feeling of heart not beating right and blood pressure of 212, and cellulitis in her wrist was not reported. This report was serious (Hospitalization Caused / Prolonged, and Other Medically Important Condition).; Sender's Comments: V0:  This 78-year-old white (non-Hispanic/Latino) female patient was hospitalized for chest pain, palpitations, and blood pressure of 212 within the hour of receiving COVID-19 VACCINE AD26.COV2.S for the prevention of symptomatic SARS-CoV-2 virus infection.  Concurrent illness included white coat hypertension, asthma, severe allergy to codeine; denies smoking and have abstained from alcohol.  The patient complained of "bad chest pain" described as heavy pressure on the chest and that she could feel her "heart was not beating right/heart feeling wonky/top of her heart beating faster than the bottom".  Blood pressure was 212 when it was checked, the patient was transported to the emergency room where echocardiogram showed that her ventricle was functioning at 40% of normal; Troponin was 113 (or 116).  The patient was started on nitroglycerin and heparin drip.  CT Angiogram of veins and arteries done 2 days after the vaccination showed no clot; by the attending cardiologist thought that some kind of clot might have been dissolved. Due to difficulty of doing the angiogram, the patient had cellulitis in her wrist with pain and discomfort in arm and wrist; the patient was taking cephalexin and percocet for the cellulitis and pain.   No other details reported.  The short latency and the advanced age confounded the event.  The information available precludes a complete and meaningful assessment.  However, considering the temporal relationship and recently evolving theories in the literature about COVID infections and vaccinations, potential vaccine contribution cannot be excluded.  Additional information was requested.