Fatigue common after myocardial infarction

Half of all patients who undergo myocardial infarction are experiencing onerous fatigue four months after the infarction. The patients who are most fatigued are those who perceive the infarction as a sign of chronic illness, those who experience the illness as difficult to control, and those who believe that the illness has a large impact on their life. These are the conclusions of a thesis presented at the Sahlgrenska Academy, University of Gothenburg, Sweden.

Just over 200 persons completed a questionnaire one week after they had experienced an infarction and again four months later. Many of the patients were also interviewed.

Around half of the patients stated that they felt onerous fatigue four months after the infarction. One third of the patients exhibited expressed fatigue, while one fifth also exhibited symptoms of depression.

"Many people experienced the fatigue as new, and different. It was not related to physical effort or a lack of rest; it occurred unpredictably and could not be attributed to any definite cause", says nurse Pia Alsén, author of the thesis.

Improvements in treatment during the acute phase of a myocardial infarction have lead to significantly more patients surviving, and to shorter periods of hospitalisation. However, medical treatment is not sufficient on its own to ensure a good long-term prognosis. Patients must also change their lifestyle, and many of them do not manage to carry out the changes that are needed. Further, some patients do not participate in the rehabilitation programmes that are available.

"The patients' perception of their illness can be crucial in determining whether they benefit from this part of the treatment or not. A better understanding of the patients' perceptions of their illness can enable us to adapt the information individually for each patient, and encourage more patients to enter the follow-up programmes", says Pia Alsén.

More patients perceived their illness to be chronic four months after the infarction.

"The perception that the condition was a chronic one depended on the extent to which the patients reflected over what had happened. Those who were unwilling to examine causes and correlations perceived the infarction as an isolated event", says Pia Alsén.

A further factor that influenced the patients' perceptions of their illness was whether they felt that they could influence the illness themselves, or whether they placed their trust in medication and other external factors. The patients' belief that they could take control of their situation through such measures as changes in lifestyle decreased after four months.

More information:

I. Alsén, P., Brink, E. & Persson, L-O. (2008). Patients´ illness perception four months after a myocardial infarction. Journal of Clinical Nursing, 17(5A), 25-33.

II. Alsén, P., Brink E. & Persson, L-O. (2008). Living with incomprehensible fatigue after recent myocardial infarction. Journal of Advanced Nursing, 64(5), 459-68.

III. Alsén, P., Brink, E., Brändström, Y., Karlsson, B. & Persson, L-O. Fatigue after myocardial infarction: Relationships with indices of emotional distress, and sociodemographic and clinical variables. (Submitted for publication)

IV. Alsén, P., Brink, E., Brändström, Y., Karlsson, B. & Persson, L-O. Illness perceptions after myocardial infarction; relations to fatigue, emotional distress, and health-related quality of life. (Submitted for publication)

Provided by University of Gothenburg (news : web)

   

• deatopmg - Jun 05, 2009
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  The fatigue experienced by the patients is, from my experience, NOT due faulty perception because of their reflection of their illness.
  I would bet that all 200 of the people in the study were on one statin or another, at maximum dose, after their "event". The most common side effect of statin over-medication is FATIGUE or worse - somewhere in the range of 40 - 50%. (In one statin trial about 45% of the patients were excluded from the "official" portion of the trial because of side effects - this information was hidden but we know it thanks to some disgusted physicians originally involved in the study. Not surprisingly, the reported results of the trial included something like: the statin was well tolerated with side effects no different than placebo).
  Low dose statins do do good things (pleotropic effects unrelated to cholesterol reduction) when taken after an "event" for 6 mo. to a yr. Taken longer than that there is simply no more improvement in outcome.)
  High dose statins are simply toxic with serious side effects leading to non-compliance in 40 - 50% of the patients and little improvement in long term outcome for theose remaining. The real outcomes are actually greater mortality in women and elderly men.
  Coenzyme Q-10 should always be taken with statin therapy at any dose.
  Big pharma does not want you to know these truths. HMMM, I wonder if there is any connection between big pharma and this study?
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