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

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. © 2009 by the American Paraplegia Society.