Related Experiment Video
Updated: May 2, 2026

Acupoint Application as a Traditional Chinese Medicine Treatment for Fatigue Associated with Chronic Obstructive Pulmonary Disease
Published on: September 5, 2025
Fatigue in the presence of coronary heart disease
Ann L Eckhardt1, Holli A Devon, Mariann R Piano
1Ann L. Eckhardt, PhD, RN, is Assistant Professor, School of Nursing, Illinois Wesleyan University, Bloomington. Holli A. DeVon, PhD, RN, is Associate Professor; Mariann R. Piano, PhD, RN, is Professor and Department Head; Catherine J. Ryan, PhD, RN, is Clinical Assistant Professor; and Julie J. Zerwic, PhD, RN, is Professor and Executive Associate Dean, Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago.
Insights
Stable coronary heart disease patients experience significant fatigue, with women reporting higher intensity and interference. Depressive symptoms uniquely predict fatigue levels in this population.
Area of Science:
- Cardiology
- Psychology
- Health Services Research
Background:
- Fatigue is a common, disabling symptom in various cardiovascular conditions.
- Fatigue has not been previously studied in patients with stable coronary heart disease (CHD).
Purpose of the Study:
- To describe fatigue levels in stable CHD patients.
- To identify demographic, physiological, and psychological correlates of fatigue.
- To examine the association between fatigue and health-related quality of life.
Main Methods:
- 102 patients with stable CHD completed validated questionnaires for fatigue, depressive symptoms, and quality of life.
- Qualitative interviews were conducted with a subset of patients to explore fatigue experiences.
- The study employed a partially mixed sequential dominant status design.
Main Results:
- 40% of patients reported significant fatigue.
- Women reported higher fatigue intensity and interference than men.
- Depressive symptoms were the only significant predictor of both fatigue intensity and interference.
Conclusions:
- Clinically relevant fatigue is present in patients with stable CHD.
- Standardized measures may underestimate the fatigue burden, as patients may adapt and discount their symptoms.
- Depressive symptoms are a key target for managing fatigue in this population.
Background:
Fatigue is a prevalent and disabling symptom associated with many acute and chronic conditions, including acute myocardial infarction and chronic heart failure. Fatigue has not been explored in patients with stable coronary heart disease (CHD).
Objectives:
The purpose of this partially mixed sequential dominant status study was to (a) describe fatigue in patients with stable CHD; (b) determine if specific demographic (gender, age, education, income), physiological (hypertension, hyperlipidemia), or psychological (depressive symptoms) variables were correlated with fatigue; and (c) determine if fatigue was associated with health-related quality of life. The theory of unpleasant symptoms was used as a conceptual framework.
Methods:
Patients (N = 102) attending two cardiology clinics completed the Fatigue Symptom Inventory, Patient Health Questionnaire-9, and Medical Outcomes Study Short Form-36 to measure fatigue, depressive symptoms, and health-related quality of life. Thirteen patients whose interference from fatigue was low, moderate, or high participated in qualitative interviews.
Results:
Forty percent of the sample reported fatigue more than 3 days of the week lasting more than one half of the day. Lower interference from fatigue was reported on standardized measures compared with qualitative interviews. Compared with men, women reported a higher fatigue intensity (p = .003) and more interference from fatigue (p = .007). In regression analyses, depressive symptoms were the sole predictor of fatigue intensity and interference.
Discussion:
Patients with stable CHD reported clinically relevant levels of fatigue. Patients with stable CHD may discount fatigue as they adapt to their symptoms. Relying solely on standardized measures may provide an incomplete picture of fatigue burden in patients with stable CHD.
Related Concept Videos
Coronary Artery Disease III: Clinical Manifestations
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
Imbalances in Cardiac Output
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
Heart Failure III: Clinical Manifestations
Coronary Artery Disease I: Introduction
Coronary Artery Disease II: Pathophysiology

