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 →
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
Quinn, Kieran L, Lam, Grace Y, Walsh, Jillian F, Bhéreur, Anne, Brown, Adam D, Chow, Chung Wai, et al. (2023). Cardiovascular Considerations in the Management of People With Suspected Long COVID.. The Canadian journal of cardiology. https://doi.org/10.1016/j.cjca.2023.04.003
BibTeX
@article{mecfsatlas-quinn-2023-cardiovascular-considerations,
author = {Quinn, Kieran L and Lam, Grace Y and Walsh, Jillian F and Bhéreur, Anne and Brown, Adam D and Chow, Chung Wai and Chung, Kit Yan Christie and Cowan, Juthaporn and Crampton, Noah and Décary, Simon and Falcone, Emilia L and Graves, Lorraine and Gross, Douglas P and Hanneman, Kate and Harvey, Paula J and Holmes, Sheila and Katz, Gabrielle M and Parhizgar, Parinaz and Sharkawy, Abdu and Tran, Karen C and Waserman, Susan and Zannella, Vanessa E and Cheung, Angela M},
title = {Cardiovascular Considerations in the Management of People With Suspected Long COVID.},
journal = {The Canadian journal of cardiology},
year = {2023},
doi = {10.1016/j.cjca.2023.04.003},
note = {PubMed: 37030518},
url = {https://www.mecfsatlas.com/evidence/quinn-2023-cardiovascular-considerations},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-27. https://www.mecfsatlas.com/evidence/quinn-2023-cardiovascular-considerations
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