Small heart syndrome in patients with chronic fatigue syndrome

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