Fatigue may significantly impair the quality of life for a patient with advanced heart failure. It is often multifactoral. Finding the causes allows for interventions that may be able to improve the patient's condition.

Reasons for fatigue in a patient with heart failure:

(1) poor sleep associated with

(1a) orthopnea or paroxysmal nocturnal dyspnea

(1b) depression

(1c) sleep apnea

(1d) drug effects

(2) anemia associated with:

(2a) chronic gastrointestinal blood loss associated with aspirin therapy

(2b) anemia of chronic disease

(2c) comorbid conditions

(3) complications of diuretics with overdiuresis and/or hypokalemia

(4) effects of beta-blockers

(5) depression and/or anxiety

(6) impaired oxygen delivery

(7) deconditioning

(8) obesity and poor nutrition

(9) poor adherence

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