Cardiovascular problems in ME/CFS
Cardiac and cardiovascular problems occur as part of a wide range of signs and symptoms in ME/CFS.
Circulatory problems in the Canadian Consensus Criteria for ME/CFS[edit | edit source]
- neurally mediated hypotension
- postural orthostatic tachycardia syndrome (POTS)
- delayed orthostatic hypotension
- heart palpitations
- fluid retention
- extreme pallor
ME International Consensus Criteria symptoms[edit | edit source]
Cardiovascular symptoms may include (but are not limited to):
- inability to tolerate an upright position - which includes:
- heart palpitations with or without cardiac arrhythmias
The Institute of Medicine (2015) symptoms[edit | edit source]
- dysautonomia, including:
Other symptoms[edit | edit source]
- bradycardia (slow heart rate)
- chest pain
- dyspnea (breathlessness)
- endothelial dysfunction
- heart rate variability abnormalities
- hypotension (low blood pressure)
- low blood volume
- poor circulation (including cold hands and feet)
- reduced cardiac volume
- small heart syndrome
- small left ventricle (in the heart) and
- short QT interval
Notable studies[edit | edit source]
- 2006, Shortened QT interval: a distinctive feature of the dysautonomia of chronic fatigue syndrome - (Abstract)
- 2008, Small Heart Syndrome in Patients with Chronic Fatigue Syndrome - (Abstract)
- 2015, Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle - (Abstract)
- 2016, Reduced cardiac volumes in chronic fatigue syndrome associate with plasma volume but not length of disease: a cohort study - (Full text)
- 2016, Chronic fatigue syndrome in women assessed with combined cardiac magnetic resonance imaging - (Full Text)
- 2017, Elevated brain natriuretic peptide levels in chronic fatigue syndrome associate with cardiac dysfunction: a case control study - (Full text)
- 2018, Cardiovascular characteristics of chronic fatigue syndrome - (Full Text)
- 2019, Evidence of altered cardiac autonomic regulation in myalgic encephalomyelitis/chronic fatigue syndrome - (Full text)
See also[edit | edit source]
- Endothelial dysfunction
- Cardiac signs and symptoms list
- Vascular signs and symptoms list
- Two-day cardiopulmonary exercise test
- Invasive cardiopulmonary exercise test
Learn more[edit | edit source]
- Heart Palpitations, Heart Pounding and Heart Fluttering - Oh Lord!..A Cardiologist on Heart Racing and Arrhythmias in Chronic Fatigue Syndrome - Health Rising
- "Cardiac Symptoms and Abnormalities Documented in CFS Patients: (A summary of 4 studies by Lerner et al.)" by the Massachusetts CFIDS/ME & FM Association
References[edit | edit source]
- Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7-115, doi:10.1300/J092v11n01_02
- Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
- Institute of Medicine (US); Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (February 10, 2015), Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness
- Newton, Julia L.; Finkelmeyer, Andreas; Petrides, George; Frith, James; Hodgson, Tim; Maclachlan, Laura; MacGowan, Guy; Blamire, Andrew M. (2016). "Reduced cardiac volumes in chronic fatigue syndrome associate with plasma volume but not length of disease: a cohort study" (PDF). Open Heart. 3 (1). doi:10.1136/openhrt-2015-000381.
- Verrillo, Erica (2012). Chronic Fatigue Syndrome Treatment: A Treatment Guide (2nd ed.). Erica Verrillo.
- Tomas, Cara; Finkelmeyer, Andreas; Hodgson, Tim; MacLachlan, Laura; MacGowan, Guy A; Blamire, Andrew M; Newton, Julia L (2017). "Elevated brain natriuretic peptide levels in chronic fatigue syndrome associate with cardiac dysfunction: a case control study". Open Heart. doi:10.1136/openhrt-2017-000697.
- Miwa, Kunihisa; Fujita, Masatoshi (2008). "Small Heart Syndrome in Patients with Chronic Fatigue Syndrome". Clinical Cardiology. 31 (7): 328–333. doi:10.1002/clc.20227. PMID 18636530.
- Miwa, Kunihisa (July 2015). "Cardiac dysfunction and orthostatic intolerance in patients with myalgic encephalomyelitis and a small left ventricle". Heart and Vessels. 30 (4): 484–489. doi:10.1007/s00380-014-0510-y. PMID 24736946.
- Naschitz, J; Fields, M; Isseroff, H; Sharif, D; Sabo, E; Rosner, I (2006). "Shortened QT interval: a distinctive feature of the dysautonomia of chronic fatigue syndrome". Journal of Electrocardiology. 39 (4): 389-94. doi:10.1016/j.jelectrocard.2005.10.014. PMID 16895768.
- Olimulder, MA; Galjee, MA; Wagenaar, LJ; van Es, J; van der Palen, J; Visser, FC; Vermeulen, RC; von Birgelen, C (2016). "Chronic fatigue syndrome in women assessed with combined cardiac magnetic resonance imaging". Netherlands Heart Journal. doi:10.1007/s12471-016-0885-8. PMID 27561279.
- Bozzini, S; Albergati, A; Capelli, Enrica; Lorusso, Lorenzo; Gazzaruso, C; Pelissero, G; Falcone, C (2018). "Cardiovascular characteristics of chronic fatigue syndrome". Biomedical Reports. 8 (1): 26–30. doi:10.3892/br.2017.1024. PMC 5772628. PMID 29399336.
- Nelson, Maximillian J; Bahl, Jasvir S; Buckley, Jonathan D; Thomson, Rebecca L; Davison, Kade (October 2019). "Evidence of altered cardiac autonomic regulation in myalgic encephalomyelitis/chronic fatigue syndrome". Medicine (Baltimore). 98 (43): e17600. doi:10.1097/MD.0000000000017600. PMC 6824690.
postural orthostatic tachycardia syndrome (POTS) - A form of orthostatic intolerance where the cardinal symptom is excessive tachycardia due to changing position (e.g. from lying down to sitting up).
orthostatic intolerance (OI) - The development of symptoms when standing upright, where symptoms are relieved upon reclining. Patients with orthostatic intolerance have trouble remaining upright for more than a few seconds or a few minutes, depending upon severity. In severe orthostatic intolerance, patients may not be able to sit upright in bed. Orthostatic intolerance is often a sign of dysautonomia. There are different types of orthostatic intolerance, including postural orthostatic tachycardia syndrome (POTS).
heart rate (HR) - the number of times the heart beats within a certain time period, usually a minute
dysautonomia disorders of the autonomic nervous system that cause disturbances in all or some autonomic functions, may cause problems regulating autonomic functions, including heart rate, blood pressure, body temperature, and digestion. Can cause symptoms including lightheadedness, fainting, unstable blood pressure, and orthostatic intolerance.
myalgic encephalomyelitis (M.E.) - A disease often marked by neurological symptoms, but fatigue is sometimes a symptom as well. Some diagnostic criteria distinguish it from chronic fatigue syndrome, while other diagnostic criteria consider it to be a synonym for chronic fatigue syndrome. A defining characteristic of ME is post-exertional malaise (PEM), or post-exertional neuroimmune exhaustion (PENE), which is a notable exacerbation of symptoms brought on by small exertions. PEM can last for days or weeks. Symptoms can include cognitive impairments, muscle pain (myalgia), trouble remaining upright (orthostatic intolerance), sleep abnormalities, and gastro-intestinal impairments, among others. An estimated 25% of those suffering from ME are housebound or bedbound. The World Health Organization (WHO) classifies ME as a neurological disease.