Heart issues; High blood pressure; Elevated heart rate; This spontaneous case was reported by a nurse and describes the occurrence of CARDIAC DISORDER (Heart issues), HYPERTENSION (High blood pressure) and TACHYCARDIA (Elevated heart rate) in a 65-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) (batch nos. 003C21A and 039B21A) for COVID-19 prophylaxis.     The patient's past medical history included Hormone therapy since an unknown date. Concurrent medical conditions included Tremor, Vitamin D low, Chronic pain and Thyroid disorder. Concomitant products included HYDROMORPHONE for Chronic pain, ESTROGENS ESTERIFIED, METHYLTESTOSTERONE (ESTRATEST) for Hormone therapy, LEVOTHYROXINE for Thyroid disorder, CLONAZEPAM for Tremor, VITAMIN D [VITAMIN D NOS] for Vitamin D deficiency.   On 14-Apr-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On 13-May-2021, received second dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) dosage was changed to 1 dosage form. On an unknown date, the patient experienced CARDIAC DISORDER (Heart issues), HYPERTENSION (High blood pressure) and TACHYCARDIA (Elevated heart rate). At the time of the report, CARDIAC DISORDER (Heart issues), HYPERTENSION (High blood pressure) and TACHYCARDIA (Elevated heart rate) outcome was unknown.      DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Blood pressure measurement: High. On an unknown date, Heart rate: Elevated. On an unknown date, Ultrasound scan: (Negative) Negative for any clots..     For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter did not provide any causality assessments.   Other medications included Augmentin from 30-Jun-2022 to 07-Jul-2022, 500-125mg 1 tablet every 12 hours for 7 days for Urinary tract infection.  Patient received Paxlovid tablet from 09-Jul-2022 with batch no. GC8236 and expiry date was Mar-2023, 150 (x 2 100mg), 300mg, 100mg dose pack 3 in the morning and 3 at night for COVID positive for the third time.  Patient received Macrobid capsule from 08-Jul-2022, 100mg take 1 capsule by mouth twice a day for Urinary tract infection.  Patient thought she thought she might be having a drug-drug interaction with Paxlovid and Macrobid. She had not think it was the Paxlovid. She wanted to go through a couple of medications to see if that could be the culprit. She would like to finish this Paxlovid out. One she was going to eliminate was Macrobid. Her symptoms were nausea, dizziness and she had severe muscle cramps in her legs and her big toe. She did not think the symptoms were caused by Paxlovid, she thought they were from the Macrobid causing it to interact with the Paxlovid.  On 10-Jul-2022, she woke up and her left leg was severely cramping. Then on the reporting day morning she woke up and her right leg, it was the worst intense cramp she ever had and her right toe went straight up and she could not get it down. Outcome improved, gone now. She thought it was a drug interaction with her muscles.  Regarding any other relevant testing, treatment or medical intervention she had an ultrasound on her left leg to rule out any micro clots. This was because after she took second shot of Moderna Vaccine she developed heart issues, high blood pressure and elevated heart rate. When she told the doctor about the leg cramps he ordered the ultrasound which was negative for any clots.  Patient was having chronic pain and she saw doctor for this. She had leg cramps before this event onset but they came very infrequently. She has had the leg cramps on and off, usually maybe once every month or two. For a while she switched to Fentanyl but was not on Fentanyl long. She was told the Paxlovid might decrease the effectiveness of pain medicine, but she had no idea, so far she could not tell any difference anyway.  Patient had urinary tract infection, gynecologist rechecked her urine, saw gynecologist on 30-Jun-2022, did urine test with a culture, that was the only testing she had. She had a urinary and bladder and kidney infection. She was on Augmentin for 7 days for the urinary tract infection. She went to the urgent care because she wanted to go on another round on the Amoxicillin but the nurse practitioner would not do it.  Patient had upper respiratory infection for about a month.