felt a huge pressure in his chest and his hands were white and pale;  put his pulse ox on and it was reading 88 for O2 sat and his heart rate was in the 120s; felt a huge pressure in his chest and his hands were white and pale;  put his pulse ox on and it was reading 88 for O2 sat and his heart rate was in the 120s; felt a huge pressure in his chest and his hands were white and pale;  put his pulse ox on and it was reading 88 for O2 sat and his heart rate was in the 120s; Severe Heart Palpitations; he felt like his heart was pounding though his chest, he was sick, and felt like he was going to pass out; felt like his heart was going to explode out of his chest; blood pressure was 197/97 and his pulse was 101. Caller states they retook his blood pressure and it was 167/97 and pulse was 101; Tachycardia; felt like his heart was going to explode out of his chest; This is a spontaneous report from a contactable pharmacist.   A 31-years-old male patient received first dose of bnt162b2 (Solution injection; Batch/Lot Number: EW0185), via an unspecified route of administration, administered in Arm Left on 16Jul2021 at 15:00 as single dose (at the age of 31-years-old) for covid-19 immunisation. The patient medical history and concomitant medications. The patient previously took fluzone (fluconazole) and had difficulty breathing with Fluzone, gotten the Flublock several times. Patient was not allergic to eggs. Patient did not receive any prior vaccinations within 4 weeks. The patient stated that he had his first Covid Vaccine on Friday 16Jul2021, and he started having severe heart palpitations on Saturday and he ended up going to the emergency department (ED). It was stated he felt like his heart was pounding though his chest, he was sick, and felt like he was going to pass out. It was further stated that he didn't know what it was, but his heart was pounding through his chest. When he got to the ED his blood pressure was 197/97 and his pulse was 101. They retook his blood pressure and it was 167/97 and pulse was 101. The doctor at the ED blew him off and said this was a common reaction to the vaccine, heart palpitations. He wanted to know if that was a common reaction, man, he felt like his heart was going to explode out of his chest. He had more palpitations and then they finally broke. The next day, on 17Jul2021, he had the palpitations again. he tried to walk and get them to calm down, tried laying down and it was still not going down, so he went back to the ED because his heart was still beating through his chest. A day prior to this report (re-ported as yesterday) 03:00 a.m, the palpitations started again, and it lasted 4 hours. He took a video with his phone of his pulse ox showing his heart rate of 119. He was still trying to calm down and it would go down to 80 but then it would go back to 100. He could get his pulse to come down but then it would go straight back up for 4.5 hours and then they finally stopped yesterday around 20:00-21:00. His pulse so far at rest was back in the 60s sometimes 50s, and he was not going through the oh my god he was going to die in his chest. The tachycardia started at 10:30-11:00 on Saturday, and it would go for several hours and then go back to normal, then it would start pounding again and then it was normal overnight, he thought it was over and then Sunday morning he was checking with his pulse ox and it was in the 60s like it normally was. He got in his truck because his friend was coming over and he felt a huge pressure in his chest and his hands were white and pale so went home and put his pulse ox on and it was reading 88 for O2 saturation and his heart rate was in the 120s. He started walking to de-stress himself and his color came back to his hands, but his heart was still pounding, so he walked on the treadmill for 30 minutes, and his O2 sat came back up, and the pressure was slightly relieved. He sat in his recliner and leaned back and tried to do vagal maneuvers and deep breathing, and he felt it started to go down and rev back up again and it wouldn't stay down and on his pulse ox his heart rate would go down to 70s and 80s and back up to 100s. He did deep breathing and it would go up and down up and down. He decided he didn't know how much more his heart could take, so he went back to the ED. They did an EKG, CBC, CMP, and Troponins because it was the second day of a high heart rate, but they all came back normal. The troponins were undetectable so no heart damage. They say it was a strong fight or flight reaction and if it doesn't go away in a few days, he needed to do something else.   A day prior to this report (reported as yesterday) he woke up at 03:00 a.m. and his heart was pounding through his chest again. Prior to this, his heart was feeling like it literally was going to explode so he recorded it with his phone going up and down up and down, because when he would get to the ED it was back to normal and it was hard to get a diagnosis. He video taped it several times. A day prior to this report (yesterday) in  morning it lasted 4.5 hours and then his heart rate went back to the 60s. It was stated that now for 24 hours it has been back in the 60s and like normal. The 60s was at rest, sometimes dropping down to the 50s, but it stays in the 60 range maybe hits the 70 range. He would say this was serious. For 3 days, he couldn't do anything, and he thought he was going to die. It was stated that now it appeared to have went away, but it was pretty scary. He has never had that issue randomly show up. The patient under-went lab tests and procedures which included blood pressure measurement: 197/97 and 167/97. On 18Jul2021, blood test was normal, electrocardiogram was normal, heart rate was 120s and oxygen saturation was 88. On 19Jul2021, heart rate was 119. The event blood pressure was 197/97 retook his blood pressure and it was 167/97 resolved on 17Jul2021; Heart rate high, Oxygen saturation decreased and Chest pressure resolved on 19Jul2021; and Palpitations, Tachycardia resolved on 20Jul2021.  No further information was provided.; Sender's Comments: Based on the information currently provided (plausible time association), it cannot be fully excluded that the bnt162b2 might have played a contributory role in triggering the occurrence of reported events.   The impact of this report on the benefit/risk profile of the Pfizer product is evaluated as part of Pfizer procedures for safety evaluation, including the review and analysis of aggregate data for adverse events. Any safety concern identified as part of this review, as well as any appropriate action in response, will be promptly notified to Regulatory Authorities, Ethics Committees and Investigators, as appropriate.