FATIGUE : HEART DISEASE SYMPTOMS

While fatigue is a common complaint of patients with heart disease, it is also a very elusive and subjective symptom—a common symptom of many physical diseases as well as depression. Basically, cardiacrelated fatigue will be of recent onset. The individual will begin the day with a relatively normal energy level, then become increasingly tired through the day to the point of exhaustion. This is because the heart muscle has become weakened and lost its ability to pump enough blood and oxygen for the body to function normally. Fatigue associated with the diminished pumping ability of the heart is often described by individuals as weakness or heaviness of the legs. Such individuals also tend to eat poorly and may develop malnutrition. This type of fatigue may occur with or without shortness of breath. Heart disease patients also may experience fatigue because of their medications. Fatigue maybe noted in about 10 percent of people on blood-pressurelowering drugs. Other physical causes of fatigue include anemia and most major chronic diseases, including hypothyroidism, diabetes mellitus, and lung disease. People who feel tired when they awaken and remain tired throughout the day with little variability are more likely to have a psychological disorder than heart disease. Fatigue is a major and common symptom of undiagnosed depression. It may also occur temporarily in people who are under a lot of stress or who simply have not been getting enough sleep. Finally, there is some good news for healthy elderly individuals who experience fatigue because they chronically wake up too early in the morning. New research on sleep/wake cycles is showing that early-morning awakening, which generally means waking up at around 4:00 A.M. and being unable to return to sleep, is a common finding in the elderly. Because these people may find it impossible to go back to sleep, they often will feel fatigued in the early evening and be ready for bed by 7:00 P.M. Researchers have discovered that aging can set the normal biological clock back by several hours. Experiments in resetting the biological clock with timed exposures to light and dark are now proving successful in reducing fatigue. When heart disease and psychological problems have been eliminated as a cause of fatigue in older individuals, a referral to a sleep center may be of benefit.