Quinn, Kieran L, Lam, Grace Y, Walsh, Jillian F et al. · The Canadian journal of cardiology · 2023 · DOI
This review examines how doctors should evaluate and treat heart-related symptoms in people with long COVID. It highlights that about 15% of Canadians infected with COVID-19 develop persistent symptoms lasting more than 12 weeks, including fatigue, shortness of breath, chest pain, and irregular heartbeats. The authors emphasize that doctors need to consider conditions like ME/CFS, postexertional malaise (symptom flare-ups after activity), and dysautonomia (problems with the autonomic nervous system) when evaluating these patients.
This guideline is important for ME/CFS patients because it recognizes the significant overlap between long COVID and ME/CFS, and explicitly directs clinicians to consider postexertional malaise when evaluating cardiac symptoms. By integrating patient perspectives and acknowledging dysautonomia and activity-related symptom exacerbation, it may help prevent harmful interventions and improve diagnostic accuracy for patients with these complex conditions.
This guideline does not establish the prevalence, pathophysiology, or optimal treatment for specific cardiac complications of long COVID—it synthesizes existing evidence rather than presenting new research data. It also does not determine whether cardiac symptoms in long COVID are primarily organic (structural/physiological) or related to dysautonomia and postexertional malaise, nor does it provide definitive proof that specific diagnostic tests distinguish long COVID from ME/CFS or other conditions.
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 →
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