Chest Pain in a 15-Year-Old Boy Following Administration of Second COVID-19 Vaccine Dose

A 15-year-old boy with no previous medical history presented to a local emergency department 2 days after receiving his second dose of the Pfizer-BioNTech COVID-19 vaccine.History revealed that during the afternoon after he had received the second dose, the patient began feeling general malaise and chills that progressed into headaches.The following day, upon awaking, the patient developed dull, burning, substernal chest pain that radiated to the throat and ears that he described as tightness.The pain was alleviated by leaning forward and exacerbated by deep inspiration.He also had related numbness and tingling in his arms and hands.The patient attempted to relieve his symptoms with the use of acetaminophen, which resulted in mild improvement of symptoms.Persistence of symptoms despite acetaminophen usage prompted the patient to present to the hospital.While at the emergency department, he was afebrile and hemodynamically stable.Laboratory analysis with complete blood count (CBC), chest x-ray (CXR), and electrocardiogram (ECG) revealed normal white blood cell, elevated hemoglobin at 17.8, no acute findings on CXR, and sinus rhythm with reported possible left ventricular hypertrophy on ECG.Troponin was elevated at 0.96 ng/mL (This is a distinct use of the unit "ng/mL."Later values from Loma Linda University Children's Health [LLUCH] are reported as "ng/L.")and C-reactive protein elevated at 3.05 mg/dL with normal erythrocyte sedimentation rate and normal creatine phosphokinase.He was then transferred to LLUCH for further inpatient management.