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Case Reports
. 2009;32(2):204-8.
doi: 10.1080/10790268.2009.11760773.

Cardiomyopathy presenting as severe fatigue in a person with chronic spinal cord injury

Alice Kam  1 , Rajini Sankaran, Kempe Gowda, Gary Linassi, Rodney Li Pi Shan
Affiliations
Case Reports

Cardiomyopathy presenting as severe fatigue in a person with chronic spinal cord injury

Alice Kam et al. J Spinal Cord Med. 2009.

Abstract

Background/objective: To describe a case of fatigue associated with cardiomyopathy in a man with spinal cord injury.

Study design: Case report.

Subject: An obese 35-year-old man with long-term ASIA A L2 paraplegia, accompanied by a 2-year history of progressive severe fatigue.

Methods: Physical examination showed obesity, hypertension, tachycardia, and pitting edema. An echocardiogram showed a 20% ejection fraction, severe dilation, and global hypokinesis in the left ventricle and mild to moderate mitral regurgitation.

Results: Symptoms improved after treatment with furosemide, warfarin, ramipril, and continuous positive airway pressure for obstructive sleep apnea.

Conclusion: Severe progressive fatigue in a patient with chronic SCI may signal cardiomyopathy. Diagnostic studies may be warranted in patients with progressive fatigue.

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Figures

Figure 1
Figure 1. ECG showed sinus tachycardia, right axis deviation, intraventricular conduction delay, poor R-wave progression, long QT interval, and inferior ST-T abnormalities.
Figure 2
Figure 2. Chest radiograph showed marked left ventricular enlargement. Peribronchial cuffing (arrow) indicated perivascular interstitial edema.
Figure 3
Figure 3. Transthoracic echocardiogram showed severe dilation of the left ventricle with marked global hypokinesis.
See this image and copyright information in PMC

References

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