Measurements of pulse rate using facial video cameras in reference to ECGs from smart devices and personal computers under low-illumination conditions

Background: Effortless and contactless monitoring technologies enable the collection of vital signs in a remote fashion without the need for physical contact with the patients. Videoplethysmography (VPG) is a technique developed to measure the pulse rate of an individual using facial video recorded by the video cameras embedded into smart devices and personal computers. It is an innovative solution to the challenges associated with the new healthcare delivery system under the SARS-CoV-1/2 pandemic. Despite these advantages, there is a knowledge gap around the performance of such technologies, especially in cardiac patients using the technology in various lighting conditions. In this work, we aim to assess the performance of the VPG technology when acquiring indoor pulse rates in patients with a history of atrial fibrillation (AF). Method(s): We evaluated the VPG technology in measuring the pulse rate in AF patients at low illumination levels. We performed an experiment in which AF patients were asked to stare at the screen of multiple devices while their VPG recordings were acquired for 25 s. We tested the VPG technology when running on 3 types of devices: an S10 smartphone (SP), a Tab3 tablet (TB), and a laptop with a Logitech C920 webcam (PC). We used a single-lead Holter ECG recorder to collect the ECG and measure heart rate (HR) at the time of the facial video. We evaluated the accuracy of measurements across a cohort of AF patients after collecting VPG signals from the three devices in various illumination conditions: 50 (dark surrounding area) to 500 (indoor office) lux, and two types of lights (LED and incandescent). We used the Bland-Altman (BA) method to measure the level of agreement between VPG- and ECG-based measurements of HR under various conditions. Finally, we measured the rates of rejection of recordings associated with each level of illumination and source of lights. Result(s): We present the results for the cohort of AF patients enrolled in this IRB-approved study from June to September 2021. Seventeen subjects were enrolled (12 men, 68+/-11 yrs). The BA plots shown in figure below do not show any bias. Furthermore, the mean difference in heart rate from VPG and ECG was inferior to 0.7 bpm across the 3 devices with confidence intervals ranging from 3 to 12 BPM (PC device showing the largest CI). The rate of rejection of VPG signal for too low quality was 60% at 50 lx, and 23% at 500 lx. The precision of heart rate measurements was higher under LED lights than under incandescent lights: measurement error+/-CI were (0.2+/-3 bpm) vs. (0.3+/-10 bpm), respectively. Conclusion(s): This VPG technology enables accurate measurements of pulse rates in patients with a history of AF when acquired in in-door conditions (low and normal illumination levels). The proposed method ensures a consistent level of accuracy even at low illumination (50 lx). This video-cardiac monitoring method represents a unique solution for physicians to measure their patient's heart rate during telemedicine visits. [Formula presented] Copyright © 2022

Acceptability, Attitude and Utilization Towards Telemedicine among People of Southern Punjab during COVID19 Pandemic

COVID-19, highly infectious, respiratory illness caused by SARS-CoV2 (Severe Acute Respiratory Syndrome) virus. It has devastating effects with high mortality.Infection become worse in patients with pre-existing medical conditions. Hospitals increased the number of critical care units in order to stabilize the pandemic's crisisand to minimize person to person transmission, installation of telemedicine networks, distant workers and internet-based health visits. Objective: To assess the acceptability, attitude and utilization towards telemedicine among COVID19 pandemic. Materials and Methods: In Sheikh Zayed Hospital, Rahim Yar Khan, a telemedicine network was quickly set during COVID-19 epidemic. A descriptive cross-sectional study comprising 144 study subjects aged between 34-58 year who seek telemedicine problems of surgery, cardiology, ENT, dermatology, gynaecology and obstetrics, pulmonology, medicine and paediatrics. Results: Out of 144 study subjectswith telemedicine consultation percent distribution of ENT and pulmonology was (48) 33.3% followed by medicine, gynaecology and obstetrics, dermatology, pediatrics and surgery.Patient's satisfaction level was 62.5% in cardiac patients. In department of gynaecology and obstetrics patients satisfaction towards telemedicine was 88.9%, (65%) patients in medicine were satisfied, followed by surgery 41.7%. Gender wise distribution showed 64.1% males were satisfied followed by 61.3% females Conclusion: The COVID-19 pandemic is creating a historic global challenge for health care providers, patients, and societies. Telemedicine is now widely available at low-cost, and broadly acceptable by physicians and patients. Current study highlights the use of telemedicine and effective applications throughout COVID-19 crisis. Telemedicine played an important role for medical practitioners to manage the COVID-19 situation.

A Study to Assess the Effect of Planned Teaching on Knowledge and Beginning Skill Regarding "Hands Only-Cpr" among the General Public from Selected Area of Kankavli

Cardiac arrest is a condition where heart suddenly stops, and the person just dies. About 10% of the deaths in India is due to sudden cardiac arrest which is also the most common factor of death in the world. In this unusual time of the Covid-19 pandemic, there is concern about the risk of a public responder contracting Covid-19 from a person when providing CPR. The vast majority of cardiac arrests (over 80%) will be in the home setting and responders are likely to be friends or family. Knowing how to perform "hands-only CPR" can save a life. A cardiac patient's chance of becoming a long-term survivor are more than doubled if someone on the scene administers prompt CPR. Healthcare workers already are at the highest risk of acquiring SARS-CoV-2, According to the AHA, and administering CPR creates additional risks, CPR can involve a number of aerosol-generating procedures that include performing chest compressions, providing positive-pressure ventilation, and establishing an advanced airway through intubation. Resuscitation can require providers to work in close proximity to one another and the patient;and the urgency to resuscitate a patient in cardiac arrest can result in lapses in infection-controlprotocols. Copyright © 2022, Anka Publishers. All rights reserved.

Protocol based versus mobile application based 6-minute walk test. A validation study

Background: The 6-minute walk test (6MWT) is often used as primary endpoint to evaluate exercise capacity in patients with heart failure. However, the 6MWT requires specialized infrastructure, personnel and need to be performed on a track according to a protocol developed by the American Thoracic Society. Especially during the first phases of the current COVID-19 pandemic, patients could not attend follow-up visits for research at the hospitals, and in several studies 6MWT measurements were lost. Purpose: The purpose of our research is to compare 6-minute walking distance (6MWD) measurements obtained according to the protocol and those obtained with a smartphone application (App) by participants themselves. Methods: For this study we asked volunteers to participate. Additionally, we included clinically stable cardiac patients from a RCT-study, where the 6MWD was a primary endpoint. Cardiac patients were excluded when they were unable to fill in questionnaires, perform physical tests, participate in Tele-Yoga (physical activity intervention) or had an expected survival less than 6 months. Participants were asked to perform the 6MWT twice: (1) According to the protocol;(2) In the home environment outside with help of an App using global environment positioning system (GPS). Additional data was collected on demographics and how they experienced the weather when walking the 6MWT outside with an App. A Bland-Altman analysis was performed, where the mean of the differences between the 6MD were calculated with the accompanying upper and lower 95% limits of agreement (95%-LOA;mean of the differences ±1.96×standard deviation of the mean of the differences). The intraclass correlation coefficient (ICC) for agreement between protocol based 6WD and 6MWD obtained with the App was calculated. Results: In total, 37 participants were included, with a mean age of 57 years old (21-85), 68% were female (n = 25) and 24% suffered from a cardiac disease (n = 9). The mean 6MWD obtained with the protocol was 613m±102 (cardiac patients 504m±91) and the mean 6MWD obtained with an App was 617m±115 (cardiac patients 493m±61). The mean of the differences between the two tests was-4m±45m (95%-LOA 84m to-99m) (Fig). Only one participant was outside the 95% LOA. This could be explained by cold weather (5-6 Celsius). The overall agreement between both 6MWD was 97% with an ICC of 0.96 (95% CI 0.91-0.98, p < 0.001). Conclusion: When it is not possible to perform the 6MWT according to the protocol, it is possible to use an App that participants can use to assess the 6MWD. Our study shows that the 6MWD measured by an App is feasible and safe. It is important to consider and document weather conditions and advice participants to avoid performing the 6MWT outside with an App when the weather conditions might influence the results, for example when the temperature is very high or very low, or when it is raining or snowing outside.

Telemedicine to Timor-Leste: Implementing an International Cardiac Telehealth Service During Population Dislocation, Floods and COVID-19

Background: The East Timor Hearts Fund (ETHF) has provided cardiac services in Timor-Leste since 2010, conducting three clinics yearly. With international border closures due to the COVID-19 pandemic, development of collaborative telehealth services was required. Methods: Scoping discussions identified major challenges (structural, patient-related and medical system-related). At two pilot clinics, patient history, investigation and management were collated. Clinic metrics were compared to an index face-to-face clinic in February 2019. Post-clinic discussions identified areas of success and shortfall in the conduct of the telehealth clinics. Results: 23 patients were reviewed at the online telehealth clinics held onsite at Timorese medical facilities. Compared to an index 2019 clinic, there were markedly lower numbers of new referrals (2 vs 190 patients, 8.7% vs 59.4%). Patients seen at the online clinic were predominantly female (17/23, 73.9%) and Dili-based (18/23, 78.3%) with a mean age of 25.9 ± 7.2 years old. The majority (12/23, 52.2%) had isolated rheumatic mitral valve disease. Investigations including electrocardiography, pathology, echocardiography and 6-minute walk tests were conducted in select patients. Medication advice was provided for 10 (43.5%) patients. 11 patients (47.8%) were deemed to require urgent intervention. Post-clinic discussions indicated general satisfaction with telehealth clinics, although frustration at current inability to provide interventional services was highlighted. Conclusion: Our pilot telehealth clinics indicate that capacity-building telemedicine can be rapidly implemented in an emergency setting internationally. Clinic design benefits from careful identification and resolution of challenges to optimise flow. Cardiac patients in Timor-Leste have a significant burden of disease amenable to intervention.

The Effect of Sedation with Inhaled Anesthetics on Cognitive and Psychiatric Outcomes in Critically Ill Adults: A Systematic Review

Rationale: The COVID-19 pandemic has renewed interest in the use of inhaled anesthetics for sedation of ventilated critically ill patients. Compared to intravenous sedatives, inhaled anesthetics reduce lung inflammation, time to extubation, and ICU length of stay. However, their impact on cognitive and psychiatric outcomes is less clear. In this systematic review we summarize the impact of inhaled sedatives on cognitive and psychiatric outcomes in ventilated critically ill patients. Methods: We searched MEDLINE, EMBASE, and PsychINFO for studies from 1970 - 2021 that assessed cognitive and psychiatric outcomes in critically ill adult patients sedated with inhaled anesthetics. We included case series, observational, cohort, and randomized controlled trials. Outcome(s) of interest included cognition, anxiety, depression, hallucinations, psychomotor recovery, and PTSD, as well as instruments for assessing these outcomes. Results: We identified a total of twelve studies that examined at least one of our outcomes of interest (16 total outcomes). Four studies were in post cardiac arrest survivors, three in post-operative (non-cardiac) patients, two in post-operative cardiac patients, and three more in mixed medical-surgical patients. Seven studies reported incidence of delirium, two assessed neurologic recovery post cardiac-arrest, and two examined ICU memories. One study reported on each of anxiety, depression, hallucinations, PTSD, psychomotor recovery, and long-term cognitive dysfunction more than 3 months following ICU discharge. Of the seven studies reporting on delirium, only one reported an increase in delirium for those sedated with intravenous sedation compared to volatile. The remaining studies did not report any difference in delirium incidence between modes of sedation. Similarly, no difference between sedation methods were observed for neurologic recovery following cardiac arrest, anxiety, depression, hallucinations, PTSD, psychomotor recovery, or long-term cognitive dysfunction. The most commonly used tool used was the CAM-ICU tool (delirium outcome;3 studies). Five studies used subjective chart review to assess their outcome of interest, or did not report their method of assessment. Conclusions: Few studies examined cognitive and psychiatric outcomes in critically ill adults sedated with volatile anesthetics. As volatile anesthetics offer a promising alternative mode of sedation in the ICU, future studies should incorporate assessment of these important patientcentered outcomes using validated objective tools during and following hospital stay.

Outcomes from a digital cardiovascular prevention and rehabilitation programme delivered in Ireland during COVID 19

Background & Aim: COVID 19 has accelerated the uptake and acceptance of digital health tools for the prevention and management of Cardiovascular Disease. With health systems being urged to learn from the pandemic and to reassess how they will deliver services in future, robust audit and evaluation of digital interventions are required to inform best practice. This study aims to evaluate the clinical outcomes of a digital CVD prevention and rehabilitation programme which was established during COVID 19 to provide cardiac patients with efficient and timely access to a home-based, structured, comprehensive programme of care. Methods: Developed and delivered by an interdisciplinary team (Nurse Prescriber, Physiotherapist, Dietitian, Cardiologist), the core components of this 12 week programme included, behavioural change support, lifestyle modification, medical risk factor management and electronic prescribing of cardio-protective medication. To support self-management, patients were provided with a Fitbit, blood pressure monitor and a workbook to support goal setting and overall tracking of progress. Patients were given access to a bespoke web-based platform and invited to attend weekly (2hr) group-based sessions, which included an exercise component and an interactive educational workshop. Results: Over a 4 month period, 105 patients were referred with an uptake rate of 73% (n=77). Of these, 97% (n=75) enrolled in the programme, with an 85% (n=64) completion rate. Significant improvements in CVD risk factors were observed between initial and end of programme assessment. The proportion of patients meeting guideline-recommended physical activity targets increased from 14 to 82% (p<0.001), mean BMI (kg/m2) reduced from 28.7 to 27.7 (p<0.001), mean Mediterranean diet score improved from 5.2 to 7.3 (p<0.001), and anxiety and depression levels ≥8 (Hospital Anxiety and Depression score) both reduced by more than 50% (p<0.001). The proportions achieving the recommended blood pressure (<130/80 mmHg) and LDL cholesterol targets (<1.4 mmol/L) increased from 24 to 68% (p<0.001) and 14 to 41% (p<0.001), respectively. Conclusion: Outcomes from this programme demonstrate that digital CVD prevention and rehabilitation programmes can achieve the recommended lifestyle, medical and therapeutic targets associated with reduced CVD events and improved health outcomes. This programme represents a scalable, accessible and effective option to deliver vital CVD preventive care in the patient's home.

INNOVATIVE TELEMONITORED MODEL OF PHYSICAL EXERCISE PRESCRIPTION IN SECONDARY PREVENTION DURING THE QUARANTINE

Introduction: COVID-19 pandemic induced the emanation of extraordinary measures like quarantine, that can be considered a risk factor for both physical and mental health in the population. In particular, gym's closure and the need to stay home didn't allow people to perform physical activity easily, with a consequent worsening of cardiovascular risk factors. During quarantine some general recommendations have been disseminated, but little is known about specific guidelines for home-based exercise prescription in patients with cardiovascular disease. Therefore, the purpose of this study is to develop home-based physical exercise programs for cardiac patients referred to the Center for Exercise Science and Sports of University of Ferrara. Methods: On the basis of exercise capacity obtained from the last functional evaluation, performed in presence before the closure, three structured workouts were realized following the guidelines. They are composed as follows: warm-up, strenght and balance exercises alternate to indoor walking, cool-down. Patients received an explicative iconographic via e-mail or smartphone. Some domiciliary sessions were supervised by an operator through video connection. Results: All patients showed excellent compliance with the proposed program. Adherence has been verified through biweekly recalls. No adverse events occurred. Conclusions: Telemonitored exercise prescription in cardiac outpatients was effective and safe, helping to prevent negative consequences of the abrupt cessation of physical activity due to COVID-19 pandemic. These evidence could be useful even after the end of pandemic, for all those patients that are less likely to participate in traditional cardiovascular rehabilitation programs because of difficulties in reaching facilities or leaving home.

Evaluating prognostic role of cardiac biomarkers in COVID-19 patients

INTRODUCTION : The COVID-19 pandemic has created havoc in India with total deaths crossing 0.4 million. Cardiac biomarkers are found to be associated with poor outcome in COVID-19 patients having concomitant cardiac diseases. But the prognostic value of cardiac biomarkers in cardiac and non-cardiac patients following COVID-19 disease was not thoroughly investigated. This study was designed to investigate prognostic role of cardiac biomarkers in COVID-19 patients with cardiac disease. METHODS: This retrospective study was conducted in the Department of Clinical Biochemistry, M.G.M. Medical college & M. Y. hospital, Indore. Four cardiac biomarkers, Trop-I, Myo, CK-MB, and BNP were considered for evaluation. Laboratory confirmed COVID-19 patients were divided in two groups, with and without concomitant cardiac disease. The differences of cardiac biomarker levels between the groups were compared using the Wilcoxon signed-ranks test. RESULTS: Out-off 632 admitted patients, 512 were found evaluable. of 512 eligible patients, 58 (11.3 %) had a history of cardiac disease. A total of 31 (6.0%) allcause death occurred during the follow-up, 8 (13.8%) deaths occurred in the cardiac disease group and 23 (5.0%) occurred in the non-cardiac group. For cardiac patients, the AUC of Trop-I, CK-MB, Myo, and BNP was found 0.660, 0.512, 0.753 and 0.712, respectively. Myo, had the highest prognostic value, followed by BNP. CONCLUSION: Increased levels of Myo and BNP have significant prognostic relevance. Our study can help to understand the prognosis of cardiac patients with COVID-19 disease. However, further study is needed.

During Covid-19 lockdown, staying-at-home in a rural area was associated with a healthier lifestyle and lower psychological distress in chronic cardiac patients

Background: Healthy lifestyle, which are keystones in management of chronic cardiac patients, could be challenged during the lockdown. Purpose: In patients with Chronic coronary syndrome (CCS) or congestive heart failure (CHF), to evaluate the impact of the place of residence during the Covid-19 lockdown on lifestyle behaviours. Methods: Randomly selected subjects among 250 patients with CCS (from RICO survey) and 150 patients with CHF (from a HF clinic) were invited to answer to a phone-call questionnaire during the 1st COVID-19 lockdown. Urban zone was defined as ≥ 2000 inhabitants. Psychological distress was assessed by Kessler-6 score. Results: 344 questionnaires were fit for analysis (220 CCS and 124 CHF), including 66.6% male, with median (IQR) age at 70(59-78) y (Table 1). Rural location of lockdown residence was frequent (53%), and associated with less lifestyle impairment (i.e. decrease in physical activity and increase in screen-time). In contrast, patients living in urban area felt more often cramped and had a higher psychologic distress. Conclusions: During the 1st lockdown, chronic cardiac subjects from rural areas reported less unhealthy behaviors and lower rate of psychological impairment. These data may help to implement preventive action targeting urban patients.

A pilot home-based cardiac telerehabilitation program

Introduction: Tele-cardiac rehabilitation has demonstrated safety and efficacy in several clinical studies. With the outbreak of COVID-19, the centered-based CR service was totally suspended. To facilitate patients to exercise at home while being monitored. A pilot home-based cardiac tele-rehabilitation program was developed with a structured protocol at Princess Margaret Hospital (PMH) and rolled out from October 2020. Objectives: 1. To minimize the impact of suspension of in-hospital CR service due to outbreak of COVID-19. 2. To evaluate the effects and develop a home-based CR program for remote rehabilitation, based on advanced technological infrastructure and complementary clinical protocols. Methodology: Target patients: Low risk cardiac patients who fulfil the intake criteria, able and willing to use digital monitoring devices including blood pressure machine, smart watch and smart phone. Program design: The program will last for 12 weeks and consists of education, exercise training and relaxation training. Each consenting patient will be given a training kit containing a training log-book, informative educational leaflets and a set of QR codes to access our home-made education, exercise training & relaxation practice videos. Individual phone consultation by multidisciplinary will be scheduled once a week at the first five weeks. Patients can view the video at their own convenience, and then discuss or ask questions during phone follow-up. Individualized exercise will be prescribed according to patients' age, mobility and cardio fitness level. Patients can follow the designated video to do exercise at home. They will be instructed to measure and record their blood pressure, heart rate, and rate perceived exertion (RPE) before and after exercise. Physiotherapist will phone call patient to monitor and coach patients. Evaluation: All patients will undergo a detailed face-to-face assessment at baseline and at 12-week. They are including 6-minute walk test, body mass index (BMI), waist circumference, blood test for lipid profile, etc. In addition, patients will also request to fill in a set of questionnaires to measure the physical activity level, functional performance and psychological fitness. Conclusion: It believes that tele-rehabilitation is a more cost-effective model compared to center-based CR. It enables a new direction for the CR program.

Role of web-based programs in heart disease prevention and rehabilitation in the covid-19 era

Objectives: Cardiovascular disease (CVD) is the leading noncommunicable cause of mortality and morbidity globally. In-person education and awareness programs conducted as part of the CVD prevention efforts have either come to a standstill or have been replaced by web-based programs in the COVID-19 era. This study describes the design and execution of web-based programs to improve awareness and educate cardiac patients during the pandemic. Methods: All web-based education/awareness sessions conducted since the start of the government-enforced lockdown in India till date (23 March-10 September 2020) were included. A multidisciplinary team consisting of Physician, Physiotherapist and Dietician worked completely online to maintain continuity of service to previously enrolled patients and to develop comprehensive web-based programs for newly enrolling patients. Patient education sessions were incorporated into the homebased CVD prevention/rehabilitation programs, which also consisted of supervised exercise sessions. Web-based awareness programs about CVD prevention strategies during the pandemic were provided to corporate employees, paying special attention to the psychosocial challenges of working from home, and to the general public. Google Meet or Zoom was used for the audiovisual presentation followed by discussion. Results: Our team provided 28 web-based education sessions and 6 awareness webinars for a total of 185 individuals during this period. The topics covered are provided in the Table. The enrolees and their family members actively participated in the sessions and interacted during the discussion. The feedback was that the communication was clear and that the online sessions were effective. The only barrier was the occasional technical snag or connectivity issue, which hindered the continuity of the session briefly. Conclusion: There has been a huge sea change in the way healthcare has been delivered during the COVID-19 pandemic and CVD prevention services are no exception. Web-based programs with online sessions replacing inperson sessions are proving to be effective in patient education and awareness creation and might be the way forward even after the pandemic in resourcelimited settings like India.

Covid-19 pandemic: We connected!

The COVID-19 pandemic has resulted in enforced and prolonged social and physical distancing. For cardiac patients, this has led to suspension of group exercise classes, whereas many healthcare providers were re-deployed to the frontlines of the COVID-19 battle. Strict travel restrictions within and between countries have also led to many families being separated from one another in different parts of the world, leading to significant stress, anxiety and even depression. Find out how both patients and healthcare workers have been impacted by the pandemic, how technology has played a part in delivering cardiac rehabilitation remotely, as well as available resources for stress relief.

Baseline audit of iron deficiency anaemia in elective cardiac surgery and the introduction of a new multidisciplinary management pathway

UK guidelines have recommended preoperative screening and treatment of anaemia in major surgery since 2015.1 We audited rates of anaemia in elective cardiac surgery in our centre and developed a pathway to manage these patients. Iron deficiency anaemia, in cardiac surgical patients in the UK, has a prevalence of between 23% and 45%. Although still debated, there is evidence efficient treatment may decrease transfusion requirement and risk, perioperative morbidity and mortality, and shorten ICU and hospital stays.2 We retrospectively reviewed notes from 100 patients undergoing elective primary coronary artery bypass grafting, valve replacement surgery, or both between August 22, 2019 and February 11, 2020. Twelve patients had to be excluded as a result of misclassification. Using electronic records we reviewed blood results at the time of booking and on the day of surgery and audited if treatment for iron deficiency had been offered. At booking, 28.4% (25/88) of our sample were anaemic (haemoglobin <130 male, <120 female). The average time between booking and surgery was 84 days. Of the 25 anaemic patients, four had iron studies performed and one patient received iron therapy. On the day of surgery, 44 patients had blood tests repeated;47.7% were anaemic. Eight patients who were anaemic at booking had no repeat blood tests and were likely still anaemic. Nine patients had become anaemic since booking and 11 of the 25 anaemic patients had lower haemoglobin levels. Given the low rate of repeat blood tests, the real number of patients anaemic on the day of surgery is likely to be higher (∼47.7–65.9%). Given the prevalence of anaemia in our sample population, the long period from booking to surgery, and the surprising increase in anaemia on the day of surgery, we developed a new management algorithm. All cardiac patients now have iron studies at the time of listing and treatment is initiated as per the algorithm (Fig. 6) if they are iron deficient. This work is currently being extended to all of our elective patients undergoing major surgery. Unfortunately, our surgical service has been severely disrupted by COVID-19, decreasing our elective workload and thus delaying re-audit to assess the efficacy of our interventions at this time. References 1. National Institute for Health and Care Excellence (2015). Available from (accessed January 2020) 2. Klein AA, Collier TJ, Brar MS, et al. Anaesthesia 2016;71: 627–35 [Formula presented]

Post-COVID myalgic encephalomyelitis in chronic heart disease patient: A case series

Purpose of Study Myalgic encephalomyelitis (ME), also called chronic fatigue syndrome, is a condition characterized by severe fatigue that impairs a patient's ability to perform common daily activities. Criteria for ME include 6 months of fatigue-limited daily activities, unrefreshing sleep, and symptom exacerbation following physical or mental strain, and orthostatic intolerance. New reports indicate that ME incidence may be higher in specific patient populations. This study was designed to investigate the association between ME and Cardiovascular disease in patients recovering from COVID-19 infection. Methods Used The patient population used for this study includes 19 patients that were referred to the Amarillo Heart Group in Amarillo, TX who also tested positive for Covid-19 at least 6 months prior to September 1, 2021. The patients that fit this timeline were asked a series of standardized questions and rate the severity of their symptoms on a scale of 0 to 5, with 0 being the absence of symptoms and 5 being the most severe. Two sets of questions were created and named Life Spheres Criteria (4 questions) and Symptoms Criteria (3 questions) based on the 2015 IOM Diagnostic Criteria for CFS. Rating more than 1 Life Spheres question as a 3 or higher or rating all 3 Symptoms Criteria questions as a 3 or higher indicated Chronic Fatigue Syndrome. Information from the survey, including time since infection, demographics, and question scores, were analyzed. Summary of Results Our study included 10 women and 10 men, with the average amount of time since Covid-19 infection being 328.17 ± 41.36 days. Worsening of symptoms with mild exertion was the most commonly endorsed criteria (3.58 ± 1.64) and the least common criterion was fatigue reducing activity in school (2.00 ± 1.94). Women scored higher in every category except reduced activity in school when compared to men. However, there was no significant difference in symptom scores between the two groups with the Combined Fatigue Score being 2.89 ± 1.47 for women and 2.67 ± 1.59 for men. Nearly all symptom scores significantly positively correlated with one another, meaning if one category was high it was likely for other categories to be high as well. Ultimately, when looking at the Cumulative Pearson Correlation Scores, reduced social life, difficulty concentrating, and symptoms worsening with mild exertion were found to be most predictive of a high Combined Fatigue Score. Conclusions In this case series, over 80% of patients met the criteria for Post-COVID Myalgic Encephalomyelitis. While the link between ME and both COVID-19 and cardiovascular disease has been established, little is known about the severity of ME in patients who have a history of both cardiovascular disease and COVID-19 infection. To our knowledge, this is the first study to examine ME in patients with both of these predisposing conditions. A high degree of clinical suspicion for ME should be used when screening and treating cardiac patients who have been infected with COVID-19.