scholarly journals 770 Small heart and single coronary artery in a young patient with chronic fatigue syndrome: a case report

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Cristina Poleggi ◽  
Silvia Perfetti ◽  
Davide Restelli ◽  
Alessia Perna ◽  
Rocco Donato ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Coronary Artery ◽  
Chronic Fatigue Syndrome ◽  
Stroke Volume ◽  
Rare Case ◽  
Chronic Fatigue ◽  
Anomalous Origin ◽  
Single Coronary Artery ◽  
Fatigue Syndrome ◽  
Small Heart

Abstract Aims Chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) is a clinically defined condition reported mostly in adults, characterized by fatigue and unexplained aspecifical symptoms. Patients with CFS/ME frequently have reduced stroke volume with an inverse relation between cardiac output and post-exertional malaise severity. We describe a rare case of a young man affected by CFS/ME, small heart, and anomalous anatomy of left main coronary artery (LMCA). Methods and results A 19-year-old Caucasian male referred to our clinic complaining weakness, lack of concentration, and sleepiness. He suffered by CFS/ME, D hypovitaminosis, inflammatory bowel disease, and exocrine pancreas insufficiency. Blood tests revealed no pathological findings. Faecal exams documented intestinal dysbiosis and low pancreatic elastase. He was treated with oxygen-ozone rectal insufflations and probiotics. Physical examination was unremarkable. Electrocardiogram showed normal sinus rhythm. Echocardiogram revealed reduced diameters of the left ventricle (LV), normal aortic root dimensions and, in a five-chamber apical view, a binary structure that seemed to cross the aorta perpendicularly. Cardiac magnetic resonance (CMR) found reduced LV stroke volume (34 ml/m2) and end-diastolic volume (57 ml/m2) together with reduced end-diastolic wall mass (51 g/m2). Right ventricle volumes were reduced too. In addition, the exam confirmed the anomalous origin of LMCA stemming from the proximal segment of right coronary artery and following a retro-aortic course. Mechanism of CFS/ME remains unknown, although various factors have been implicated, including immune activation, chronic viral infection, and emotional disorders. A considerable number of patients affected by CFS has an anatomically small heart. Small heart syndrome, in fact, may contribute to the onset of CFS/ME. Previous studies hypothesized that clinical manifestations of CMS/ME were caused by reduced venous return, cardiac output, and heart mass, together with decreased arterial oxygen saturation. Single coronary artery is an uncommon congenital anatomic abnormality identified by a single coronary ostium giving rise to all arteries supplying the heart. Thus, we reported a rare case of a very young man affected by chronic fatigue syndrome and small heart, investigated not only with echocardiogram but also with CMR, not often used in this clinical setting. More, we found an anomalous origin of LMCA. From literature, it’s not reported any cases of a patient including these three rare conditions (CFS/ME, small heart, and single coronary artery). Conclusions This case highlights that CFS/ME together with small heart is a condition possible also in young people. More studies and reports could be necessary to better define the association between cardiac congenital anomalies and CFS/ME. 770 Figure

scholarly journals Chronic fatigue syndrome: comments on deconditioning, blood volume and resulting cardiac function

2009 ◽  
Vol 118 (2) ◽  
pp. 121-123 ◽  
Author(s):  
Julian M. Stewart
Keyword(s):  
Cardiac Output ◽  
Chronic Fatigue Syndrome ◽  
Stroke Volume ◽  
Blood Volume ◽  
Sedentary Lifestyle ◽  
Orthostatic Intolerance ◽  
Bed Rest ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
Cardiac Stroke Volume

Cardiovascular and autonomic dysfunction have been suggested to underlie the symptoms accompanying CFS (chronic fatigue syndrome). In the present issue of Clinical Science, Hurwitz and co-workers have investigated whether deficits were present in cardiac output and blood volume in a cohort of patients with CFS and if these were linked to illness severity and sedentary lifestyle. The results clearly demonstrate reduced cardiac stroke volume and cardiac output in more severely afflicted patients with CFS, which is primarily attributable to a measurable reduction in blood volume. Similar findings are observed in microgravity and bed rest deconditioning, in forms of orthostatic intolerance and, to a lesser extent, in sedentary people. The circulatory consequences of reduced cardiac output may help to account for many of the findings of the syndrome.

Comparison of the finger plethysmography derived stroke volumes by Nexfin CO Trek and suprasternal aortic Doppler derived stroke volume measurements in adults with myalgic encephalomyelitis/chronic fatigue syndrome and in healthy controls

2021 ◽  
pp. 1-14
Author(s):  
C. (Linda) M.C. van Campen ◽  
Freek W.A. Verheugt ◽  
Peter C. Rowe ◽  
Frans C. Visser
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Stroke Volume ◽  
Chronic Fatigue ◽  
Calibration Procedure ◽  
Myalgic Encephalomyelitis ◽  
Tilt Test ◽  
Healthy Controls ◽  
Tilt Testing ◽  
Fatigue Syndrome ◽  
Finger Plethysmography

BACKGROUND: Finger plethysmography derived stroke volumes are frequently measured during tilt table testing. There are two algorithms to determine stroke volumes: Modelflow and NexfinCO Trek. Most tilt studies used Modelflow, while there are differences between the two algorithms. OBJECTIVE: To compare stroke volume indices by Nexfin CO Trek (SVINexfinCOTrek) with suprasternal Doppler derived SVI (SVIDoppler) in healthy controls (HC) and myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) patients during tilt testing. These patients may have a large SVI decrease during the tilt enabling a large range of SVI to be studied. METHODS: One hundred and fifty-four patients and 39 HC with a normal tilt test were included. Supine and end-tilt SVIDoppler and SVINexfinCOTrek were compared using the Bland-Altman analysis. Also, the effect of calibrating supine SVINexfinCOTrek to SVIDoppler was studied RESULTS: Supine and end-tilt SVINexfinCOTrek were significantly higher than SVIDoppler: both P< 0.005. Bias, limits of agreement, and percent error (PE) were high with PE’s between 37 and 43%. The calibration procedure resulted in an acceptable variance with a PE of 29%. CONCLUSIONS: SVINexfinCOTrek overestimates stroke volumes compared to SVIDoppler, leading to high PE’s. Calibration reduced variance to an acceptable level, allowing SVINexfinCOTrek to be used for assessment of SVI changes during tilt testing

Chronic fatigue syndrome: a hormonal origin? A rare case of dysmenorrhea membranacea

2008 ◽  
Vol 279 (5) ◽  
pp. 717-720 ◽  
Author(s):  
Joan Veldman ◽  
Boudewijn Van Houdenhove ◽  
Jasper Verguts
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Rare Case ◽  
Chronic Fatigue ◽  
Fatigue Syndrome

Chronic fatigue syndrome: illness severity, sedentary lifestyle, blood volume and evidence of diminished cardiac function

2009 ◽  
Vol 118 (2) ◽  
pp. 125-135 ◽  
Author(s):  
Barry E. Hurwitz ◽  
Virginia T. Coryell ◽  
Meela Parker ◽  
Pedro Martin ◽  
Arthur LaPerriere ◽  
...  
Keyword(s):  
Cardiac Output ◽  
Chronic Fatigue Syndrome ◽  
Blood Volume ◽  
Sedentary Lifestyle ◽  
Cardiac Contractility ◽  
Chronic Fatigue ◽  
Group Differences ◽  
Control Groups ◽  
Cardiac Volume ◽  
Fatigue Syndrome

The study examined whether deficits in cardiac output and blood volume in a CFS (chronic fatigue syndrome) cohort were present and linked to illness severity and sedentary lifestyle. Follow-up analyses assessed whether differences in cardiac output levels between CFS and control groups were corrected by controlling for cardiac contractility and TBV (total blood volume). The 146 participants were subdivided into two CFS groups based on symptom severity data, severe (n=30) and non-severe (n=26), and two healthy non-CFS control groups based on physical activity, sedentary (n=58) and non-sedentary (n=32). Controls were matched to CFS participants using age, gender, ethnicity and body mass. Echocardiographic measures indicated that the severe CFS participants had 10.2% lower cardiac volume (i.e. stroke index and end-diastolic volume) and 25.1% lower contractility (velocity of circumferential shortening corrected by heart rate) than the control groups. Dual tag blood volume assessments indicated that the CFS groups had lower TBV, PV (plasma volume) and RBCV (red blood cell volume) than control groups. Of the CFS subjects with a TBV deficit (i.e. ≥8% below ideal levels), the mean±S.D. percentage deficit in TBV, PV and RBCV were −15.4±4.0, −13.2±5.0 and −19.1±6.3% respectively. Lower cardiac volume levels in CFS were substantially corrected by controlling for prevailing TBV deficits, but were not affected by controlling for cardiac contractility levels. Analyses indicated that the TBV deficit explained 91–94% of the group differences in cardiac volume indices. Group differences in cardiac structure were offsetting and, hence, no differences emerged for left ventricular mass index. Therefore the findings indicate that lower cardiac volume levels, displayed primarily by subjects with severe CFS, were not linked to diminished cardiac contractility levels, but were probably a consequence of a co-morbid hypovolaemic condition. Further study is needed to address the extent to which the cardiac and blood volume alterations in CFS have physiological and clinical significance.

scholarly journals Small Heart Syndrome in Patients with Chronic Fatigue Syndrome

2008 ◽  
Vol 31 (7) ◽  
pp. 328-333 ◽  
Author(s):  
Kunihisa Miwa ◽  
Masatoshi Fujita
Keyword(s):  
Chronic Fatigue Syndrome ◽  
Chronic Fatigue ◽  
Fatigue Syndrome ◽  
Small Heart
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