Small Heart Syndrome in Patients with Chronic Fatigue Syndrome.

Clin Cardiol. 2008 Jul 17;31(7):328-333. [Epub ahead of print]

Miwa K, Fujita M.

Affiliation: Division of Internal Medicine, Fukuda General Hospital, Osaka.

NLM Citation: PMID: 18636530


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.

RESULTS: 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 (n 
= 34), narrow chest (88%), orthostatic dizziness (44%), foot coldness 
(41%), pretibial pitting edema (32%), r-kidney palpability (47%), and 
mitral valve prolapse (29%), 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.


Copyright (c) 2008 Wiley Periodicals, Inc.