MAGICAL MEDICINE: HOW TO MAKE AN ILLNESS ... - Invest in ME

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basis of the postviral fatigue syndrome. This condition is characterised by recuperation through rest. The myocardium,
however, cannot rest – except terminally” (NR Grist. BMJ 1989:299:1219).
1990
“A significant group have cardiac symptoms” (Professor Peter Behan, Cambridge Conference Report, 17 th
March 1990; ME Association Medical Update 1990: 2).
1990
“There is a high incidence of cardiomyopathy in CFS patients” (Dr Jay Goldstein, Director of the CFS
Institutes, Anaheim Hills; member of the Faculty of the Department of Psychiatry, University of California;
CFIDS Reporter, Oregon, October 1990).
1991
“The patient with Post‐viral fatigue syndrome (ME) is referred to a cardiologist almost always because of
chest pain. In viral pericarditis, as with ME, there is now abundant evidence that the disease process arises
from an abnormal response to a viral infection. Chest pain is variable in character. It is sometimes severe, sharp
and stabbing, or it may be dull and aching. It is unrelated to exertion, although the patient frequently feels the pain to
be worse after a day of increased physical activity. The pain may last for several hours or even days. It frequently
occurs centrally but even in the same patient may recur on a different occasion in the right or left chest or the back. It
is commonly aggravated by sudden movement, change of posture, respiration or swallowing. Palpitations are
frequent, with sinus tachycardia being a common and troublesome symptom. The diagnosis of the cause of
chest pain in ME rests almost entirely on careful clinical evaluation. Pericarditis may continue or recur for many
years and, like ME, be a distressing and debilitating illness. There is alas no way of predicting how long the
condition will persist, and no reliably successful means of treating it” (Post‐viral Fatigue Syndrome and the
Cardiologist. RG Gold. In: Post‐Viral Fatigue Syndrome. Ed: Rachel Jenkins and James Mowbray. John
Wiley & Sons, 1991).
1993
Evidence of repetitively negative to flat T waves on 24‐hour ECG monitoring was found in some ME/CFS
patients (Lerner AM et al. Chest 1993:104:1417‐1421).
1994
Abnormal left ventricular dynamics (i.e. an abnormal pumping mechanism) were demonstrated in
ME/CFS patients, including abnormal wall motion at rest; dilatation of the left ventricle, and segmental
wall motion abnormalities (Dworkin HJ, Lerner AM et al. Clinical Nuclear Medicine 1994:19:8:675‐677).
1994
“As with any chronic inflammatory condition affecting the central nervous system, the T2‐bright foci on
MR (magnetic resonance) in ME/CFS may represent perivascular cellular infiltrate and / or reactive
demyelination of the surrounding white matter….these abnormalities may reflect the result of a
vasculopathy specifically involving the small vessels of the cerebral white matter; indeed, the distribution of
lesions on MR in ME/CFS is similar to that observed in occlusive arteriolar disease of any origin. The cortical
defects measured with SPECT may result from decreased flow through cortical arterioles owing to
vasculitis. Specifically, on the basis of our observations, the white matter abnormalities seen on MR
images may represent chronic demyelination, which appears to be irreversible” (Detection of Intracranial
Abnormalities in Patients with Chronic Fatigue Syndrome: comparison of MR imaging and SPECT.
Schwartz RB, Komaroff AL et al. Am J Roentgenol 1994:162:935‐941).