Angina simultaneously diagnosed with the recurrence of Myalgic Encephalomyelitis/ Chronic Fatigue Syndrome, by Koki Li, Yuki Otsuka, Yasuhiro Nakano, Daisuke Omura, Kou Hasegawa, Mikako Obika, Keigo Ueda, Hitomi Kataoka and Fumio Otsuka in Diagnostics Vol 11 no. 3 [10.3390/diagnostics11030460] 6 March 2021

Case report abstract:

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) mainly affects young adults and can have a potential impact on social functioning. As this syndrome is associated with endothelial dysfunction, the heart can be damaged via ischemia due to endothelial damage. This might potentially lead to heart failure, which accounts for approximately 20% of deaths among patients with ME/CFS.

While cardiac ischemia is thought be a pathophysiologically important manifestation of this syndrome, this is not yet reported. Herein, we present a case of a young female with newly diagnosed vasospastic or microvascular angina and concurrent exacerbation of ME/CFS severity. Her anginal symptoms, including exertional chest pain and transient chest discomfort, mimicked those of ME/CFS but were relieved after the administration of a calcium channel blocker.

We emphasize the possibility of concurrent angina and exacerbation of ME/CFS and the importance of detecting cardiac ischemia to avoid unfavorable outcomes.

Excerpt from discussion

In conclusion, we experienced an interesting case in which vasospastic or microvascular angina was detected along with concurrent exacerbation of ME/CFS severity. This suggested that cardiac manifestations can appear as a result of deterioration. As the symptoms experienced by patients with ME/CFS might mimic those of angina, diagnosis of the latter might be easily missed. Thus, it is pertinent that cardiac examinations be conducted in such patients to rule out the possibility of heart ischemia.