Li, Koki, Otsuka, Yuki, Nakano, Yasuhiro et al. · Diagnostics (Basel, Switzerland) · 2021 · DOI
This case report describes a young woman who experienced chest pain and worsening ME/CFS symptoms at the same time. Doctors discovered she had angina (reduced blood flow to the heart), which was successfully treated with heart medication. This case highlights that ME/CFS patients experiencing chest pain should be evaluated for actual heart problems, not assume all chest symptoms are from ME/CFS alone.
This case is important because it demonstrates that ME/CFS patients with chest symptoms require cardiac evaluation to rule out concurrent ischemic heart disease, which could otherwise go undiagnosed and lead to serious outcomes. It supports the hypothesis that endothelial dysfunction in ME/CFS may increase cardiovascular risk, potentially explaining the reported 20% of deaths attributed to heart failure in this population.
This case report does not establish how common concurrent angina is in ME/CFS patients, nor does it prove that ME/CFS causes angina. It cannot determine whether the angina and ME/CFS exacerbation were causally related or coincidentally occurred together. The findings apply only to this individual patient and cannot be generalized to the broader ME/CFS population.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Li, Koki, Otsuka, Yuki, Nakano, Yasuhiro, Omura, Daisuke, Hasegawa, Kou, Obika, Mikako, et al. (2021). Angina Simultaneously Diagnosed with the Recurrence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.. Diagnostics (Basel, Switzerland). https://doi.org/10.3390/diagnostics11030460
BibTeX
@article{mecfsatlas-li-2021-angina-simultaneously,
author = {Li, Koki and Otsuka, Yuki and Nakano, Yasuhiro and Omura, Daisuke and Hasegawa, Kou and Obika, Mikako and Ueda, Keigo and Kataoka, Hitomi and Otsuka, Fumio},
title = {Angina Simultaneously Diagnosed with the Recurrence of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome.},
journal = {Diagnostics (Basel, Switzerland)},
year = {2021},
doi = {10.3390/diagnostics11030460},
note = {PubMed: 33800953},
url = {https://www.mecfsatlas.com/evidence/li-2021-angina-simultaneously},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/li-2021-angina-simultaneously
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