Individualized Treatment in ME/CFS | David Systrom, M.D. | INIM Conference 2024

Join the COVID UPP Study: https://redcap.nova.edu/redcap/survey... In the recent INIM conference held on May 10, 2024, Dr. David Systrom discussed how he and other practitioners at Brigham and Women’s Hospital used cardiopulmonary exercise tests and several case studies to treat patients initially with dyspnea. A deeper look has uncovered that other illnesses are causing the patients’ lack of energy and difficulty breathing. They also discovered that many of these patients are suffering from chronic diseases such as POTS and ME/CFS. The cardiopulmonary exercise tests also showed a lot of commonalities between ME/CFS and Long COVID. This study that focused on the individualized treatment in ME/CFS concluded, based on all the data that has been used, the prevalence of small fiber neuropathy, therefore a neurovascular dysregulation at play. Timestamps: 00:00 Introduction 04:09 The Cardiopulmonary Exercise Test 07:24 Case study: Dyspnea and Exertional intolerance 09:51 There’s more to dyspnea 11:22 What is preload failure? 15:06 Relationship of impaired oxygen extraction to small fiber neuropathy 16:56 Case Study: Commonalities Between ME/CFS and Long Covid 17:59 Dysautonomia results in left-to-right shunting 19:10 What causes the shortness of breath? 21:34 What’s the treatment? 23:50 Conclusion Dr. David Systrom is a Brigham and Women’s Hospital pulmonary and critical care faculty member and Assistant Professor of Medicine at Harvard Medical School. He has been on the Harvard faculty for over 35 years where he received NIH, AHA, Department of Defense, Dysautonomia International, and OMF funding to study various forms of exercise intolerance. Over the past five years, he has used invasive cardiopulmonary exercise testing to investigate mechanisms underlying fatigue, shortness of breath, and orthostatic intolerance in ME/CFS and PASC. His recent work suggests a commonality between neurovascular dysregulation and related hyperventilation underlying symptoms during exercise. He is also the Principal Investigator of an ongoing $8 million study of limb skeletal muscle mitochondrial dysfunction and just completed the first-ever randomized clinical trial of pyridostigmine, both in ME/CFS. Website: https://physiciandirectory.brighamand... #MECFS #myalgicencephalomyelitis #chronicfatiguesyndrome #chronicillness