BNP just went up and up; Congestive heart failure; She couldn't walk up the stairs; This is a spontaneous report from a contactable nurse (patient). A 61-year-old female patient received BNT162B2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 2 via an unspecified route of administration on 02Feb2021 (Lot Number: EL8982) as SINGLE DOSE for covid-19 immunisation, in the afternoon around 4 or 5 o'clock. Vaccination Facility Type was Nursing home/Rehabilitation Center. Medical history included psoriasis from 1986 and ongoing; stent in 2016, the doctor was sure the heart failure was not related to her stent; swollen leg from Jun2020 to an unknown date. She went to her Cardiologist, they said she has no heart failure. The Cardiologist told her the fluid from her knee drained down into her ankle that was why it was swollen, her BNP indicator was 165 at the doctor then. Concomitant medications included atorvastatin (LIPITOR) taken for cholesterol, coronary artery disease, cardiac disorder from 2016 and ongoing; clopidogrel bisulfate (PLAVIX) taken for blood viscosity decreased from 2016 to 14Apr2021, patient reported when she went to the hospital they checked for a PE or Pulmonary Embolism or blood clot, they found nothing, the cardiologist said her blood was flowing beautifully so he discontinued the Plavix; acetylsalicylic acid (BABY ASPIRIN) taken for blood thinner from 2016 and ongoing; ezetimibe (ZETIA) taken for blood thinner, start and stop date were not reported. The patient previously took the first dose of bnt162b2 on 11Jan2021 (lot number: EL0142), also at age of 61 years old, at left deltoid for covid-19 immunization; tremfya injection 100 mg every 60 days for psoriasis. The patient experienced congestive heart failure (CHF) (hospitalization, disability, medically significant) in Feb2021 with outcome of not recovered, she couldn't walk up the stairs (hospitalization) in 2021 with outcome of unknown, bnp just went up and up (hospitalization) in Apr2021 with outcome of unknown. The patient was hospitalized for events from Apr2021 to 16Apr2021. Patient report she got short of breath, which she didn't attribute heart failure, she thought it was something with her lungs. And had a cough. She reported she was so short of breath she couldn't walk up the stairs. At the beginning of the month, she was better, but she couldn't go up the stairs, and she was taking cough syrup and things which didn't help. Then she was in the emergency room either on 13Apr2021 or 14Apr2021 and then she was admitted to the hospital, and then she had CHF. This started 2-3 weeks after getting the 2nd vaccine the shortness of breath, heart congestion and wheezing. Her husband said she needs to go pulmonologist to be seen. Patient confirmed she went into the hospital on the 13Apr2021 but, it was midnight and it could have been the next day also, it varies, the time. The shortness of breath and things started in February or March started, they started slowly. She could not breath at all, it started around 2-3 weeks after the vaccine. It was so bad she could not walk around, her husband was worried he went to get the car and she waited on a bench. She could not breath. These things started before 16Mar2021, maybe, between the 15Feb2021 to 21Feb2021. Patient said CHF was heart didn't pump sufficiently anymore. She was now on disability and has a Life-Vest. She was on tons of medications. She wears Life Vest for 3 months then will get echocardiogram or MRI to see what is going on. When she went to the hospital for the CHF, her BNP was 2700 and then it went to 3500. They gave her IV diuretics in the hospital but her BNP just went up and up. This was all on the same day she went to the ER, she spent 13 hours in the emergency room. They drew labs and cardiologics then. Patient got IV diuretics in the hospital, she believed it was Lasix or Furosemide. When she was discharged for the hospital at night on the 16th, her BNP was 518, so they let her go because the diuretics worked. The diuretic was change to oral Torsemide at her discharge. Investigations included chemistry, BNP, a blood count, a metabolic panel.; Sender's Comments: Based on temporal association, the causal relationship between BNT162B2 and the events, Cardiac failure congestive, gait disturbance, brain natriuretic peptide increased cannot be completely ruled out. The impact of this report on 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, Ethic committees, and Investigators, as appropriate.