RIGHT MIDDLE AND BASILAR SEGMENTAL PULMONARY EMBOLISM; CHRONIC PULMONARY ARTERIAL HYPERTENSION; DILATED PULMONARY ARTERY; SMALL LEFT PLEURAL EFFUSION; PHLEGM; This spontaneous report received from a physician concerned a 56 year old male The patient's weight was 125 kilograms, and height was 175.2 centimeters. The patient's concurrent conditions included alcohol user, smoker, obstructive sleep apnea, asthma, tobacco abuse, high blood pressure, morbid obesity, and general pain, The patient had no known allergies and no drug abuse or illicit drug usage.  The patient received covid-19 vaccine ad26.cov2.s (suspension for injection, route of admin not reported, batch number: 202A21A, expiry: UNKNOWN) dose was not reported, 1 total, administered on 09-APR-2021 vaccination to left arm for prophylactic vaccination. Concomitant medications included salbutamol for asthma, acetylsalicylic acid for general pain, and atenolol for high blood pressure.  It was reported that about 2 weeks ago in MAY-2021, the patient started to experience shortness of breath at rest and on exertion, pain in the left side of his chest, cough, and phlegm. The patient saw his family care provider who referred him to an orthopedic physician. The patient visited physician's office for treatment of the events. On 18-MAY-2021, the patient was hospitalized with a diagnosis of pulmonary embolism. The remarkable laboratory testing results were: D-dimer of 1,716 ng/mL, chest Computed tomography (CT) angiogram showed right middle and basilar segmental pulmonary embolism without evidence of heart strain, troponin of 103 was normal, chest X-ray showed chronic pulmonary arterial hypertension, dilated pulmonary artery, and small left pleural effusion. The patient's heart was fine, had no evidence of heart failure. The patient remained hospitalized currently treated with heparin drip, Lasix, and methylprednisolone. As of 19-MAY-2021, the patient remained hospitalized and was improving since a day prior to this report. The pain and shortness of breath were better. The patient never had this problem in the past. The reporter stated that vaccination was only identifiable change in the patient's normal routine/therapy. The patient also underwent imaging CT and echocardiogram without mention of specific results. Laboratory data included: Computed tomography (CT) scan (NR: not provided) Not Provided, and Echocardiogram (NR: not provided) Not Provided. Laboratory data included: COVID-19 virus test (NR: not provided) Negative, Computed tomography (CT) angiography (NR: not provided) pulmonary embolism without evidence of heart strain, Chest X-ray (NR: not provided) chronic pulmonary arterial hypertension, Fibrin D dimer (NR: not provided) 1, 716 ng/mL, Stress test (NR: not provided) Normal, and Troponin (NR: not provided) 103 normal. Treatment medications included: heparin, methylprednisolone, and furosemide. The action taken with covid-19 vaccine ad26.cov2.s was not applicable. The patient was recovering from right middle and basilar segmental pulmonary embolism, and the outcome of dilated pulmonary artery, small left pleural effusion, chronic pulmonary arterial hypertension and phlegm was not reported. This report was serious (Hospitalization Caused / Prolonged).; Sender's Comments: V0: 20210537813-covid-19 vaccine ad26.cov2.s-right middle and basilar segmental pulmonary embolism, chronic pulmonary arterial hypertension, dilated pulmonary artery, small left pleural effusion. This event(s) is considered unassessable. 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).