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One of the most common symptoms of heart disease is fatigue, often occurring with other symptoms like shortness of breath, heart palpitations, high blood pressure, chest discomfort, and chest pain (angina). “Always fighting fatigue,” wrote one MyHeartDiseaseTeam member. Another said, “Today is another day I battle with fatigue.”
Everyone feels exhausted from time to time. But fatigue goes beyond everyday tiredness, often having a significant impact on your ability to perform daily activities and on your overall quality of life. However, you and your health care provider or cardiology team can work together to find ways to manage the symptom. Here is what you need to know about fatigue in heart disease, including what causes it and how it can be managed.
Heart disease refers to a number of conditions that affect the cardiovascular system (the heart and blood vessels). The many types of heart disease include congestive heart failure, coronary artery disease, arrhythmia, peripheral artery disease, and heart valve problems.
Fatigue refers to a feeling of intense physical or mental exhaustion. Unlike normal tiredness, it’s not caused by overexertion or lack of sleep. As one MyHeartDiseaseTeam member wrote, “Feeling fatigued, low energy, weak ... lack of strength.” Another shared that they “deal with extreme fatigue every day,” becoming “exhausted after any activity.”
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For some people, fatigue comes and goes. “Sometimes, I feel great,” wrote one member. “I have energy. Then I quickly find myself exhausted. It’s frustrating." Others find that fatigue is a constant, like one member who shared, “Can’t shake the fatigue, not feeling myself lately, but other than that, I’m hanging in there.”
This fatigue can interfere with life in major ways. “That fatigue is no fun,” wrote one member. “I want to take a walk to get some fresh air and end up huffing and puffing by the time I get out the door and half a block from the house.” Another explained how fatigue interferes with their work: “Doing OK, except for feeling physically exhausted and fatigued all day. Still falling asleep at work even when I fight to stay awake.”
“Fatigue is my biggest issue,” one member explained. “I’m tired all the time, and I sleep more and more. Things I enjoy I’m too tired to enjoy.” When this goes on for a while, fatigue can affect your overall quality of life or sense of well-being. You may even feel down or depressed, like one member who wrote, “It’s really easy when you’re tired and not feeling like your normal self to go into an emotional slump.”
In general, people with heart problems experience fatigue when their heart can’t pump enough blood to meet the body’s demands. When that happens, the body chooses to pump blood to the most vital areas first, including the heart and brain. As a result, other areas — such as the limbs and muscles — receive less blood flow, leading to the sensation of fatigue. Fatigue can be associated with muscle or kidney issues and lower cardiac function in people without diagnosed heart disease.
Beta-blockers are medications commonly taken by people living with cardiovascular disease. These drugs can contribute to fatigue and “beta-blocker fog” or difficulty thinking.
Because these medications help keep you healthy and treat your heart disease, it’s essential to work with your health care provider to determine whether they are contributing to your fatigue — and, if they are, how to combat the side effect while treating your condition.
Many MyHeartDiseaseTeam members report extreme fatigue after heart surgery. One member wrote, “It’s been three months since my surgery ... everyone says I look great, and I am doing more and more, but it’s not enough, and I get tired easily.”
Another added, “I had bypass surgery 10 months ago. I am doing better every day. However, I am still very tired.”
“I don’t think you ever get back to how you were before,” wrote another member. “I just accept how I am now and make the most of it.”
It’s normal to experience fatigue after major surgery. But if you don’t feel like you’re recovering well, talk with your doctor. Ask what you can expect for recovery, such as how long it may take and when you should start to feel better. You and your health care provider can come up with a plan to help you work through post-surgery fatigue.
Fatigue in people with heart disease can also be caused by other medical conditions, including thyroid disorders, kidney disease, sleep apnea, and anemia. If you’re experiencing fatigue, make sure to talk to your doctor. They will be able to evaluate you for other potential causes of fatigue and determine effective treatments for any conditions you might be living with in addition to heart disease.
A variety of strategies can help you manage fatigue related to heart disease.
When heart disease itself is causing fatigue, treating your condition may help alleviate the symptom. There are many treatments for heart disease, including medication, surgery, and lifestyle changes. Finding an effective treatment can help improve the overall health of your heart, allowing it to more effectively pump all the blood your body needs.
As one member explained, “I felt brand-new when I woke up from the operation and could do more than I had before, like walking and enjoying the world. You have a new lease on life because your heart has been fixed.” Another wrote, “After a year, I felt well enough to climb and bike.”
Studies have shown that increasing your activity level is one of the best ways to improve your heart health, curb weight gain, and combat fatigue associated with heart disease. This may feel counterintuitive — fatigue often makes you want to move less, not more.
Members have shared their tips for getting more exercise with heart disease. “I force myself to do things,” one wrote. Another recommended using a fitness tracker: “It helps you keep count of steps daily and monitors almost everything. I use it to force myself. I have it set to 5,000 steps a day as a must.”
If your doctor is concerned that strenuous activity might harm your heart, they may refer you to a physical therapist or cardiac rehabilitation program experienced in working with people who have heart disease. They can help you design an activity plan that will be safe and help you feel better. If you’re cleared for exercise, your physician may ask you to keep an eye on your heart rate.
Depression is very common among people with heart conditions, especially during the few months after a heart attack, heart surgery, or hospitalization. It can occur for many reasons — as a reaction to the diagnosis itself, a response to how fatigue or tiredness interferes with daily life, or as an of effect beta-blockers. The relationship between higher fatigue and lower quality of life may be more common in women than it is in men, according to a study published in Progress in Cardiovascular Nursing.
Treating depression — and the symptoms of stress, poor sleep, and inadequate relaxation that can come along with it — may help improve fatigue in some people who are living with heart disease.
Many members have tried a variety of supplements to help ease their fatigue. It’s important to note that not all supplements are right for everyone, especially those with different types of heart disease. Ask your cardiologist for medical advice before trying any new supplements. Blood tests may be needed to confirm that you need extra amounts of certain nutrients.
One member shared that they “take a caffeine pill when I wake up and ginseng before I go to work.” Others have found that vitamin D deficiency contributes to fatigue, such as a member who shared, “My vitamin D level is very low in blood work, and now I will be on vitamin D. I’ve been informed on my second-day dose I will be more energized. Looking forward to this feeling. Just the thought of not feeling drained, sluggish, etc., has me feeling blessed!”
Iron supplements may also be helpful if an iron deficiency is contributing to fatigue. You can have your iron levels tested by a simple blood test at your doctor’s office.
Are you or a loved one living with heart disease? Consider joining MyHeartDiseaseTeam today. On the online social network for people living with heart disease and those who love and care for them, you can share your story, ask questions, and join ongoing conversations. Before long, you’ll build a team of members from around the world who understand life with heart disease.
Do you struggle with fatigue caused by heart disease? Have you found ways to manage your fatigue? Share your questions, tips, or thoughts in the comments below or by posting on your Activities page.
Larry A. Weinrauch, MD, FACC, FACP, FAHA is an assistant professor of medicine at Harvard Medical School with a focus on cardiovascular disease and clinical outcomes research. Review provided by VeriMed Healthcare Network. Learn more about him here.
Sarah Winfrey is a writer at MyHealthTeam. Learn more about her here.
