worsening heart failure; DOE; worsening fatigue; weight gain; This is a spontaneous report from a contactable consumer (the patient).      A 84-year-old male patient received bnt162b2 (COVID-19 VACCINE - MANUFACTURER UNKNOWN), dose 2 via an unspecified route of administration on an unspecified date (Batch/Lot number was not reported) as single dose for covid-19 immunisation. Medical history included , cardiac valve disease , myelodysplastic syndrome , hypertension (Mother) , mitral valve incompetence , cardiac failure heart failure with mildly reduced ejection fraction , iron deficiency  , gout,  chronic kidney disease, cardiomyopathy, nonischemic cardiomyopathy, dyslipidemia; pulmonary hypertension, anemia, Barrett's esophagus, CHF, Coronary artery disease, GERD,  hypercholesterolemia, former smoker (quitted more than 10 years ago), alcohol user. Concomitant medication(s) included docusate sodium (COLACE) taken for an unspecified indication, start and stop date were not reported; allopurinol (ALLOPURINOL) taken for an unspecified indication, start and stop date were not reported; ferrous sulfate (FERROUS SULFATE) taken for an unspecified indication, start and stop date were not reported; metoprolol succinate (TOPROL XL) taken for an unspecified indication, start and stop date were not reported; simvastatin (SIMVASTATIN) taken for an unspecified indication, start and stop date were not reported; torsemide (TORSEMIDE) taken for an unspecified indication, start and stop date were not reported; tafamidis (VYNDAMAX) taken for an unspecified indication, start and stop date were not reported.  The patient previously took pantoprazole and experienced diarrhoea, torsemide and experienced constipation, on an unknown date received the first dose of unknown covid-19 vaccine.  The patient experienced worsening heart failure  (medically significant) on an unspecified date with outcome of unknown , doe (dyspnoea exertional) (medically significant) on an unspecified date with outcome of unknown , worsening fatigue  (non-serious) on an unspecified date with outcome of unknown , weight gain  (non-serious) on an unspecified date with outcome of unknown.  The patient underwent lab tests and procedures which included blood creatinine: 2.4, blood pressure systolic: between 100-120, breath sounds: decreased breath sounds, cardiac stress test: no evidence of perfusion abnormality   on 23Jun2021 no evidence of fixed or reversible perfusion abnormality , cardiovascular evaluation: dyspnea on exertion, Positive for dyspnea on exertion , echocardiogram: normal lv chamber dimension  on 15Apr2021   , ejection fraction: 27 %   Mild to moderate global systolic dysfunction with LVEF of 35-40% , electrocardiogram ambulatory: sinus rhythm with minimum heart rate   on 23Jun2021   , haematocrit: 36      , haemoglobin: 11   on   improvement in his hemoglobin from 8-10 , heart rate: on 23Jun2021 63 beats per minute.    Maximum heart rate 73 beats per minute , dilated LV with a TID ratio: 1.04,  investigation: chronic renal insufficiency, right ventricular systolic pressure: 67-72 mmHg on   RVSP of 67-72. mmHg consistent with severe pulmonary  hypertension , single photon emission computerised tomogram: presence of ttr cardiac amyloid   on 01Sep2021 grade 3 myocardial to rib uptake which means that the rib uptake is less than myocardial uptake.  The lot number for the suspect  vaccine, was not provided and will be requested during follow up.