Background: Small heart syndrome has previously been reported as neurocirculatory asthenia, associated with a small heart shadow on a chest roentgenogram. This is characterized as weakness or fatigue even after ordinary exertion, palpitation, dyspnea, and fainting, resembling patients with chronic fatigue syndrome (CFS).
Hypothesis: Small heart syndrome may be prevalent in patients with CFS.
Methods: The study population consisted of 56 patients (<50 y of age) with CFS, and 38 control subjects. Chest roentgenographic, echocardiographic, and physical examinations were performed.
Small heart syndrome (cardiothoracic ratio <!–= 42%) was significantly more prevalent in the CFS group (61%) than in the control group (24%) (p < 0.01).
In CFS patients with a small heart (number = 34 of 56)…
- Narrow chest (88%),
- Orthostatic dizziness (44%) [owing to fall in blood pressure upon rising from prone to standing position, for example],
- Foot coldness (41%),
- Pretibial pitting edema (32%) [swelling over the shin that leaves a dent when pressed and released]
- r-kidney palpability (47%) [perceivable by touch]
- And mitral valve prolapse (29%) [doesn’t close snugly]…
Were all significantly more prevalent than in the control group – and also in the CFS patients without small heart syndrome
Echocardiographic examination demonstrated significantly smaller values of both the left ventricular (LV) end-diastolic dimensions and end-systolic, and stroke volume and cardiac indexes in CFS with a small heart, as compared with control subjects with a normal heart size (42% < cardiothoracic ratio < 50%).
Conclusions: A considerable number of CFS patients have a small heart. Small heart syndrome may contribute to the development of CFS as a constitutional factor predisposing to fatigue, and may be included in the genesis of CFS.
Source: Clinical Cardiology, July 2008. 17;31(7):328-333. [Epub ahead of print] PMID: 18636530, by Miwa K, Fujita M. Division of Internal Medicine, Fukuda General Hospital, Osaka, Japan. [E-mail: firstname.lastname@example.org]