Is there an overlap of symptoms of fatigue from multiple sclerosis vs. heart disease? Can you tell the difference between MS and heart disease fatigue?

Heart disease causes fatigue. Multiple sclerosis causes fatigue. The big question, then, is: Can one distinguish between the fatigue of MS and that of heart disease?

Being that heart disease is extremely common, it’s very possible for a person with MS to also have heart disease.

However, let’s focus on how the fatigue of MS presents, and if this is different to how the fatigue of heart disease (coronary or chronic heart failure) presents.

“MS fatigue can be quite different than heart disease fatigue,” says Achillefs Ntranos, MD, a board certified neurologist specializing in multiple sclerosis and demyelinating diseases, and chief neurologist with Treat MS.

“Heart disease may cause more breathing related fatigue, feelings of being short of breath or having chest pain/tightness, whereas MS fatigue can be more mental fatigue.

“This is a generalization — but for MS it would usually feel like it would need increased mental effort, and the affected extremities would feel heavier than usual, like moving against water.

“For heart disease it would usually feel like you are running out of oxygen, as a weak heart would not provide enough blood to the muscles or remove the carbon dioxide fast enough.”

Here’s another way to understand this. Let’s suppose you’re healthy and fit.

However, even a healthy, fit person can induce “shortness of breath” if they exert themselves enough.

Imagine that you’re briskly walking on a street that’s slightly uphill.

Certainly, you can feel increased respiration and a slightly elevated effort, when compared to just walking around your backyard.

Now imagine that you feel this exact way…when walking around your backyard. THAT is what heart disease can make you feel like.

There’s no mental component. It simply feels as though your body isn’t getting enough oxygen, making the simple meandering on flat grass feel like exercise.

It would actually be a natural feeling, because it’s from not getting enough oxygen, which is a routine experience of the human body during activity.

It’s just that for some people, it requires high loads of activity to induce this, while for those with heart disease, the threshold is much lower.

In the case of multiple sclerosis, the feeling of “fatigue” would not feel as natural, but it would still be described as fatigue, lack of energy, lethargy or listlessness, or a “heavy” feeling.

You would feel as though you must mentally push yourself through the task or activity – an action that previously would have felt like a breeze.

In a nutshell, “Both types could result in reduction of endurance and athletic abilities,” says Dr. Ntranos.

Dr. Ntranos is the chief neurologist and MS specialist at Treat MS. His goal is to combine concepts of personalized medical management with evidence-based clinical decision making to maximize the treatment benefit for each MS patient.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.


Top image: ©Lorra Garrick