multi focal pneumonia; atrial fibrillation/the second worst feeling he has ever had since he had his first heart surgery; arm started hurting real bad/a severe pain that radiated down to elbow, arm, chest; This is a spontaneous report from a contactable consumer (patient). A 63-year-old male patient received bnt162b2 (PFIZER-BIONTECH COVID-19 VACCINE), dose 1 via an unspecified route of administration, administered in Arm Left on 15Mar2021(Lot Number: EN6204; Expiration Date: 30Jun2021) as single dose for covid-19 immunisation. Medical history included acute diabetes, acute thyroid disease, covid like in 2021 (10 weeks before), 3 heart surgeries with 12 stents, ongoing chronic obstructive pulmonary disease (COPD)slight case diagnosed in 2016-2017, bad thyroid from 2006 and ongoing and told he had full blown Hashimotos in 2017, bad diabetic from 2015 and ongoing  and went into diabetic type coma on 18Dec2015 (sugar when got him out of the parking lot cause he had to drive there was 738 or 768 put him in ICU from 18Dec2015-25Dec2015. Had to give him shots like every 2 hours. Started giving him insulin there but insurance wouldn't approve it so kept him on Metformin. Like 5th or 6th day got it under control), bad heart from 2007 and ongoing (In 2017 he had a heart attack they call 'widowmaker', he was told he hemochromatosis like his brother and sister. Caller stated they got it from his parents, but the doctors can't find it now. He had 3 different heart surgeries and has 12 stents in him. 9 weeks before (2021), he went to the hospital because of his heart, got a real bad heart, been put on a heart transplant list, they told him his blood tries to flow backwards and all of it's going over to the right chamber; after 2 hours after he had been admitted to the hospital they told him he had had a heart attack, level 3-they knew from blood tests they'd done. About 1 hour later said test was positive for COVID. He had no symptoms. While in hospital they gave him Zinc, Vitamin D3, Vitamin B1 and that was it. They kept him 5 days at the hospital. Also reported that went to the hospital for triple bypass heart surgery when he got in said somethings wrong, watch everything on the monitors wouldn't tell him nothing; said your widow maker is completely blocked up 99% had to go in and unblock that up so they can't do any kind of bypass on him again. The only thing they can do was heart transplant or heart graft where they take part of the left chamber and he din't have but like 18% of that left, take it come over whatever they're talking about, he doesn't know it's a heart graft whatever they're talking about there), 2 hernia operations, hemochromatosis (little sister and older brother has hemochromatosis-patient got hemochromatosis (too much iron in the blood) from 1 gene from his mother and 1 gene from his father. Brother doesn't have it anymore; but patient's and his sisters mutated); ongoing blood pressure abnormal; anxiety; ongoing wheezing; ongoing chronic Atrial fibrillation. Concomitant medications included aspirin (ASPIRIN [ACETYLSALICYLIC ACID]) taken to help blood to be thin from 2007 and ongoing; levothyroxine taken for Bad thyroid from 2006 and ongoing; metoprolol succinate taken for blood pressure from 2015 and ongoing; clonazepam taken for anxiety from 2012 to an unspecified stop date; fluticasone propionate taken for sinuses from 2015 and ongoing; insulin glargine (LANTUS) taken for diabetes from 2019 and ongoing; insulin aspart (NOVOLOG) taken for diabetes from 2019 and ongoing; salbutamol (ALBUTEROL HFA) taken for wheezing from 2018 and ongoing; budesonide, formoterol fumarate (SYMBICORT) taken for COPD from 2018 and ongoing; amiodarone (AMIODARONE) taken for atrial fibrillation from 22Mar2021 and ongoing; amoxicillin, clavulanate potassium (AUGMENTIN) taken for an unspecified indication from 22Mar2021 to 29Mar2021; apixaban taken for prevent blood clots and chronic Atrial fibrillation from 22Mar2021 and ongoing. The patient had pneumonia shot and flu shot took that in Sep2020. The was no vaccinations within 4 weeks prior to the BNT162B2.The patient previously received Xanax for anxiety from unknown date to 2012; received Humalog , Glipizide and Metformin for Diabetes. The patient got his first Pfizer COVID-19 Vaccine shot on Monday 15Mar2021 at sometime between 15:30-16:00. Not even an hour after he got the Pfizer COVID-19 Vaccine shot his arm started hurting real bad, felt like a hot ice pick was in his arm-described as it started locally just in one spot, then started getting worse going down to his elbow. About 30-45 minutes after got out of there, he was sick, didn't know what was wrong with him. Also reported as by 16:30 he felt bad and pulled up to a friends house. He would say it was an allergic reaction; starting in his arm, a severe pain that radiated down to elbow, arm, chest, it was hard to breathe since 18Mar2021. He went to a friends house after getting the shot, and by the time he got to the friend's house, he felt sick and laid down for about two hours and just kept feeling worse and worse. After that he went home and went to bed. He stayed in bed Tuesday, 16Mar2021, Wednesday, 17Mar2021 and was able to drag himself out of bed to at least go to the bathroom on Thursday morning, 18Mar2021. When he got out of bed, he couldn't breathe. When he got up Thursday morning he couldn't even move his whole left side, had to grab nightstand and pull himself up to stand up out of the bed; stumbled to the bathroom about 3 feet away.He made his way to the phone and called his sister to tell her to call an ambulance because he couldn't breathe. When he got to the emergency room he was told he was in atrial fibrillation. He stayed in the hospital with primary diagnosis as multifocal pneumonia with atrial fibrillation. Feeling like heart beating out of his chest, machine going off every 2-3 minutes. It took about 9-10 hours to get the atrial fibrillation under control. He stayed in Hospital for 4 days-admitted 18Mar2021-discharged 22Mar2021. He spoke to his heart doctor who said it was hard to breathe due to the Atrial fibrillation and all his doctors say they did not know whether it was a reaction to the covid vaccine.He heard the doctors talking and they were saying they didn't think he was going to make it. His heart rate was going between 80 and 200. He had 3 different IV's going in each arm shooting different heart medications in him and the doctor explained that the medications didn't mix well, could not go in the same IV at the same time. The patient shared that this was the second worst feeling he has ever had since he had his first heart surgery. He meant they thought he was dead or dying he lost feeling of everything. His arm felt better, but every now and again felt like a little knot or something was in there. He was breathing better, they gave him inhalers, albuterol. He thought that his heart doctor was going to start him on oxygen. He went to his Cardiologist on 01Mar2021 on Monday, 2 weeks before getting his first Pfizer COVID-19 Vaccine: cardiologist told him his triglycerides raised up about 15 was about 268. All his Cardiologist did was change his blood pressure medicine. Went to his Endocrinologist on 08Mar2021 Monday, 1 week before he took the Pfizer COVID-19 Vaccine: Endocrinologist raised his Lantus SoloStar U-100 insulin 100 units/mL (3mL) from 60 units nightly to 64 units nightly then. All his other blood tests were good, they just said keep doing what you're doing.The outcome of all the events was resolving.   Follow-up attempts are completed. No further information is expected.